What is bladder botox?
Botox is very effective in treating the symptoms of overactive bladder and urge incontinence. In the same way it prevents involuntary contraction of muscle in other areas of the body, it prevents the bladder from contracting before you are ready to urinate. It allows the bladder to store urine more effectively. Botox is a great option in women who have failed conservative therapy and medication.
How does it work?
When botox is injected into the bladder muscle, it prevents the release of a chemical called a neurotransmitter, which is what activates the muscle to contract. The presence of botox can prevent the sudden contraction of the bladder that causes urinary leakage.
How effective is it?
Studies on botox overwhelmingly show that patients have improvements in urinary frequency, urgency, urge incontinence, pad use, and quality of life scores. These studies also show increased bladder capacity. Approximately 75% of patients who undergo a botox injection will experience improvement in their symptoms within a few weeks.
How is the procedure performed?
Botox is injected into the bladder through an instrument called a cystoscope. This is done in the office. We instill a numbing medication in the bladder, which needs to sit there for about 40 minutes in order to work well. Once the bladder is numb, you will be placed in stirrups, and Dr. Kumar will insert the cystoscope under sterile conditions. The botox is injected through a very tiny needle, in several areas of the bladder in order to disperse evenly throughout the muscle. The injection takes only 5-10 minutes. Afterward, you may have slight discomfort during urination and this should subside by the next day. The botox may take anywhere from 2 days to 2 weeks to take effect on your overactive bladder symptoms.
What are the possible side effects?
Since botox relaxes the bladder muscle, it is possible to have difficulty emptying your bladder after the procedure. This happens in about 5% of patients, and it is more likely to happen in patients who already do not empty the bladder well. If you retain a large volume of urine, Dr. Kumar will empty the bladder with a small tube, and show you how to empty the bladder at home. There is a small chance of getting a urinary tract infection after the procedure, which can be treated with antibiotics if necessary. Dr. Kumar will always make sure you do not have a urinary tract infection prior to your bladder botox injection. She will order a urine culture to be done about 10-14 days prior to your procedure.
How long does it last?
Bladder botox typically lasts 6-9 months. You will know when it wears off because your overactive bladder symptoms will start to return. At this point, you could call the office to schedule a repeat injection.