Bladder Botox®

Botox® is a muscle relaxant which works by reducing uncontrolled contractions of the bladder muscle and increasing bladder capacity. This helps relieve symptoms of overactive bladder.  The procedure may be performed at the Rosemark facility or at the hospital.

PROCEDURE OBJECTIVES

The reasons to have Bladder Botox® injections are to reduce urinary symptoms such as the sudden desire to pass urine, the need to urinate frequently and urinary leakage associated with urge to urinate.

THE PROCEDURE

The Bladder Botox procedure involves a hysteroscopy. During the procedure, a hysteroscope is passed through the urethra into the bladder. Once in the bladder, the surgeon injects Botox® into the bladder wall from the inside.

Effects of the Procedure

The results of the Botox® injection usually take between three days to three weeks to take effect, so the patient will not notice a difference immediately after the injections.  Most patients find the effects of the injections last between six to nine months, although they can last longer. Repeated injections will be required each time the effects wear off.

RISKS

The risks of Bladder Botox® can be divided into those associated with the hystersope and those associated with Botox® itself.

Hysterscope

• Bleeding:  After having a hysterscope removed from the bladder the patient may find a small amount of blood in the urine. This is usually a very small amount which stops within 24 hours. Patients should seek advice immediately from the Rosemark surgeon if the bleeding persists for several days or if they are passing blood clots despite keeping well hydrated and drinking plenty of fluids.
• Infection:  Patients may develop an infection of the bladder. This may be associated with stinging or burning in the urethra, frequency of urination, pain in the lower part of the abdomen and a high temperature. The patient may just feel unwell generally. If these symptoms appear the patient should consult their Rosemark surgeon.

Botox®

• Urination Difficulty:  Approximately one in six patients can have difficulty passing urine after Botox® injections for overactive bladder.  They may be left with residual urine in the bladder after they feel they have emptied it fully. This may be seen more commonly in people with overactive bladder symptoms and neurological conditions.In either case the Rosemark doctor will ask the patient to use a catheter to empty the bladder fully. This involves passing a small tube through the urethra and into the bladder while sitting on the toilet thus allowing all of the urine to drain out. This is known as clean intermittent self-catheterization and is typically performed two to three times per day. The need to perform this reduces over time as the effects of the toxin wear off.  In cases where a patient may not be able to urinate, they should contact their Rosemark obgyn doctor.
• Allergic Reaction:  As with any medication patients may have an allergic reaction. This is rare but possible. If the patient experiences any difficulty breathing, swallowing or speaking they must seek emergency medical treatment calling 911 for an ambulance.
• Flu-like Symptoms:  Flu-like symptoms have been reported by some patients who have had Botox®. These symptoms may be experienced for a week or two after the injections. Occasionally some patients develop bladder pain following the injections. This pain is usually controlled with simple painkillers typically resolves quickly following the injections.
• Muscle Weakness:  Generalized muscle weakness is very rare but some patients world-wide have reported it in the arm and leg muscles. Such muscle weakness is mild and usually does not require a stay in the hospital as the condition resolves with time.

Summary

Patients suffering from overactive bladder symptoms may consider Bladder Botox® to relieve symptoms such as the sudden desire to pass urine, the need to urinate frequently and urinary leakage associated with the urge to urinate.

If you experience any of these symptoms, contact Rosemark for an appointment so you and a healthcare provider can discuss Bladder Botox® and decide if this is a procedure right for you.