Botox and the Bladder

Botulinum Toxin, better known as Botox, is now approved by the U.S. Food and Drug Administration to treat adults with overactive bladder.

Botox had previously been approved to treat urgency incontinence due to known neurologic injuries such as spinal cord trauma, stroke and Multiple Sclerosis. Now its use is expanded to treat patients with overactive bladder or OAB where the cause is not known.

Botox is injected into the bladder to reduce bladder contractility or relax the muscle of the bladder. Botox wears off after 4 to 9 months; therapeutic effects of the medications may last longer in some patients.

As a result of the relaxation or temporary weakening of the bladder muscle, failure to empty the bladder can occur following the procedure. To minimize the risk of incomplete bladder emptying, careful, individualized preoperative consideration is given to the amount of Botox injected and the location in the bladder the Botox is injected.

Botox injections are usually performed in the office. Urinary urgency and frequency should decrease within 5 days following injections. Urge urinary leakage should resolve as well. Therapeutic effects are greatest 2 weeks after the injection and last from 4-9 months.

Botox is an option when behavioral modifications and medications for urgency incontinence are not successful in treating symptoms. The other option for refractory urinary urgency and urgency incontinence is Interstim.