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Botox For Urinary Incontinence Procedure

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Will I Have Side Effects If I Stop Using Botox

Bladder Botox For Incontinence | Fairbanks Urology | Dr Tony Nimeh Urologist

Stopping Botox treatment doesnt cause unique side effects. But as the amount of the drug in your body decreases, symptoms of the condition you were using Botox to treat may develop.

Botoxs effects usually wear off by about 12 weeks after your last dose. Sometimes this can result in your condition coming back. For example, chronic migraine headaches may get worse than they were prior to Botox treatment after you stop the drug.

If you have questions about stopping Botox, talk with your doctor. They can discuss how stopping treatment may affect your condition.

Learn more about some of the side effects that Botox may cause.

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Bladder Botox: Side Effects

Some people experience mild pelvic or abdominal discomfort after receiving Botox in the bladder. This has been described as a sensation like period cramps. This discomfort typically doesnt last more than a couple days. Other potential side effects from Botox injections in the bladder include:

  • Urinary tract infection
  • Difficulty urinating
  • Inability to empty your bladder

These side effects are not common and are temporary. If you are experiencing any issues with urination after Botox injections in the bladder you should contact your doctor.

What Are Some Alternative Choices For The Procedure

Some of the alternatives to Botox Treatment for Overactive Bladder include the following measures:

  • Administration of medication to relax or contract the bladder muscles
  • Nerve stimulation through minimally-invasive procedures
  • Surgery to increase urinary bladder volume using graft tissue from other parts of the body
  • Reconstructive surgical procedures for urinary bladder, for severe OAB

Alternatives to Botox for Overactive Bladder may be considered in individuals who do not tolerate Botox injections.

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What Can I Expect After Receiving Botox Injections For My Bladder Problem

After receiving a Botox injection, you may have improved bladder control for about 12 weeks. Some people may still have bladder control after 24 weeks. After this period, the effect of Botox wears off, and youll need more injections.

Your experience with Botox injections may vary. If you have questions about the results you can expect with this drug, talk with your doctor. And for more information, see the How effective is Botox? section below.

What The Treatment Involves:

Botox for Overactive Bladder in Multiple Sclerosis

Botox injection treatment is administered in the office under local anesthesia. Local anesthetic is placed via a catheter and allowed to remain in the bladder for 20-30 minutes to provide numbing of the lining of the bladder. After 20-30 minutes, a small scope which is connected to a camera is placed into your bladder through the urethra and a series of injections of Botox solution are done into the muscle of the bladder using a small needle that is passed through the scope. The actual injection procedure takes about 5 minutes or less.

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Is Botox Right For Me

The answer to this question varies based on the individual. Fortunately, a urologist is happy to meet with a patient, learn about his or her overactive bladder symptoms, and perform a full patient evaluation. That way, a urologist can determine if Botox is the right treatment option.

If a urologist finds that Botox may help a patient alleviate overactive bladder symptoms, he or she will outline all aspects of the procedure to a patient. A urologist will also respond to a patientâs Botox concerns and questions to help this individual make an informed treatment decision.

Comparatively, if the potential risks of Botox outweigh the potential benefits for a patient, a urologist will provide overactive bladder treatment alternatives. A urologistâs goal is to ensure a patient can treat his or her overactive bladder symptoms for years to come. To accomplish this goal, a urologist may recommend Botox or other overactive bladder treatments tailored to a patientâs condition.

What We Offer

Boxed Warning: Spread Of Toxin Effects

This drug has a boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Receiving Botox injections can raise your risk for botulism. Botulism is a fatal condition that causes paralysis. In rare cases, Botox may spread away from where its injected to other parts of your body. This is known as botulism.

Symptoms of botulism may include:

  • muscle weakness all over your body
  • double vision or blurred vision
  • drooping of your eyelids
  • change in or loss of your voice
  • loss of bladder control
  • trouble breathing or swallowing

If you have any of these symptoms after receiving Botox injections, call 911 right away or seek immediate emergency medical care.

If you have questions about your risk for botulism from Botox injections, talk with your doctor.

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Alcohol Use With Botox

There arent any known interactions between getting Botox injections and drinking alcohol.

Keep in mind that drinking alcohol could cause your risk for certain side effects of Botox to be higher, including:

If you drink alcohol, talk with your doctor about how much is safe for you to drink during Botox treatment.

Botox Injections For Pelvic Floor Disorders At A Glance:

Botox for the Treatment of Overactive Bladder
  • Botox is a drug made from the botulinum toxin. It works by weakening or paralyzing muscle.
  • In small doses, this drug can ease the spasms that contribute to symptoms of overactive bladder and urinary incontinence.
  • Botox treatments do not cure urinary incontinence and â much like the use of Botox for facial wrinkles â reapplication of the drug is required every eight months to a year.

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How Is Botox Treatment Performed

Botox is injected directly into the bladder muscle through an instrument placed into the bladder called a cystoscope. After being positioned on an examining table, anesthetic jelly is passed into the urethra, then a catheter is passed into the bladder, and the urine is drained. Through this catheter, a local anesthetic solution is placed into the bladder to numb its lining. A small flexible needle is then introduced through the cystoscope to perform the injections. Anywhere from 10 to 30 injections are made into the bladder, and at each site a small amount of Botox solution is injected.

The procedure is usually performed on an outpatient basis, meaning that no overnight hospital stay is required. In most cases, only local anesthetic is required however, some doctors may also give sedative medication, and some prefer to perform the procedure with the patient under spinal or general anesthetic depending on the situation. Typically, the procedure takes only 10 to 30 minutes. Antibiotics are given before the procedure.

How Is Botox Given

To treat bladder conditions, Botox is given as an injection into the detrusor muscle .

At each injection appointment, adults with OAB symptoms or children with detrusor overactivity will receive a Botox injection in 20 sites, located 1 centimeter apart in the detrusor muscle.

Adults with detrusor overactivity will receive a higher dose of Botox, which is injected in 30 sites, located 1 cm apart in the detrusor muscle.

In some cases, your doctor may inject a medication before your Botox injection to help with pain.

Your doctor will monitor you for at least 30 minutes after each Botox injection. If youre using Botox to treat OAB symptoms, youll need to show that you can urinate before leaving your doctors office.

If you have questions about what to expect at your injection appointments, talk with your doctor.

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How Do Bladder Botox Injections Work

Botox injections are not just for wrinkles on your face. They also can be used to help if you have ongoing bladder continence issues. Botox is one option to treat urge incontinence or overactive bladder in people who have not had success with other treatment options.

Urinary incontinence is common and can impair your social, physical or mental well-being. Approximately 17% of women and 3% to 11% of men suffer from urge incontinence at some point in their lives.

Urge incontinence is the unintentional loss of urine caused by your bladder contracting.

How Does Botox Treatment Work

Intravesical Botox injection

Botox is a neuromodulator, which means that it can safely block nerve communication between the nerves and the bladder muscles for a series of months without damaging the nerve tissue. When used to block nerve signals to the detrusor muscle, Botox can effectively eliminate bladder spasms that may cause urinary leakage or the sudden urge to urinate without any warning.

Overactive bladder or bladder spasticity often occurs in older women, or women who may have suffered nerve damage as a result of childbirth or trauma. Botox can provide 6 to 8 months of relief and may be re-injected once the effects have worn off and have proven to be successful as a female incontinence treatment. An additional benefit of detrusor muscle Botox injections is that female urinary incontinence patients typically experience an increase in bladder capacity once the muscles no longer spasm or contract involuntarily.

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Financial And Insurance Assistance

If you need financial support to pay for Botox, or if you need help understanding your insurance coverage, help is available.

Allergan, the manufacturer of Botox, offers the Botox Savings Program, which may help lower the cost of your treatment. For more information and to find out if youre eligible for support, call 800-44-BOTOX or visit the program website.

Do You Need Anesthesia For Bladder Botox Injections

Botox bladder injections are performed as an outpatient procedure. You do not need general anesthesia for Botox injections in the bladder, but your doctor will administer a local anesthetic to temporarily numb your bladder so you will not feel the injections, similar to how a dentist numbs your mouth before filling a cavity. The local anesthetic generally wears off within one hour of completing the injections. Because Botox bladder injections do not require general anesthesia, you can drive yourself to and from your treatment.

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Botox For Overactive Bladder Urgency Incontinence And Neurogenic Lower Urinary Tract Dysfunction:

Botox injection into the bladder is a well-established treatment for overactive bladder and urgency incontinence, including urgency incontinence associated with neurological disease. It is usually used when behavioral and exercise therapies and medications have not been effective in treating symptoms. Botox has been shown to produce dramatic improvements in symptoms and quality of life in women who have not responded to or could not tolerated other treatments. At the Center for Women’s Pelvic Health at UCLA, our physicians did some of the pioneering work on use of Botox for overactive bladder and incontinence over the past 15 years. In most cases Botox can be done in an office setting with local anesthesia instilled into the bladder.

Dosage For Upper And Lower Limb Spasticity

Your Health Matters: Using Botox to treat urinary incontinence

The typical dosage of Botox for upper limb spasticity in adults ranges from 75 units to 400 units. For lower limb spasticity in adults, the typical dosage of Botox ranges from 300 units to 400 units. Dosages for limb spasticity in children are described below in the Pediatric dosage section.

The exact Botox dosage for this use depends on the size, location, and number of muscles affected. It also depends on the severity of your spasticity. The total recommended dosage for spasticity is divided into multiple injections into affected muscles.

Botox treatment for spasticity may be repeated when the drugs effect wears off. But each treatment session must be at least 12 weeks apart.

The dosage youre given for spasticity may change each time you have a session for Botox injections. Your dosage will vary depending on how your body responded to previous injections.

Note: To learn more about upper and lower limb spasticity, see the Other uses for Botox section above.

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What Should I Expect After Treatment

You should not experience significant pain during or after the Botox treatment, although it may sting or burn when urinating the first few times. You may also see some blood in the urine initially after the treatments.

It may take several days for the effect of Botox to be known. Initially, you may not notice any change in your urinary symptoms, but over several days to a week or so, you should begin to experience relief of sudden urges to urinate, and a lessening of the frequency and severity of leakage episodes. You will be able to hold your bladder for longer periods of time between urinations, and will wake up less frequently to empty your bladder. If you are taking medications by mouth to relax the bladder, you may be able to wean yourself off of these once the Botox treatment begins to take effect, and your doctor will advise you about this. We usually recommend cutting the dose in half after 1-2 weeks, then trying to stop altogether by 2-4 weeks.

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What Is The Typical Dosage For Botox

Below are commonly used dosages of Botox for bladder conditions. But your doctor will determine the right dosage to fit your needs.

For OAB symptoms in adults, the recommended dose is 100 units of Botox. This is also the maximum recommended dose for treating this condition.

For use in adults with detrusor overactivity caused by a neurological condition, the recommended dose is 200 units of Botox. This is also the recommended maximum dose for treating this condition.

Childrens dosage

Botox is used in children ages 5 years and older with detrusor overactivity caused by a neurological condition. For this purpose, the Botox dose is determined based on the childs weight:

  • For children who weigh at least 75 pounds , the dose is 200 units of Botox.
  • For children who weigh under 75 pounds, the recommended dose is 6 units of Botox for every kilogram of body weight. Your childs doctor will calculate the appropriate dose for them.

Note: Botox has other uses in addition to treating bladder problems. The dosage may be different for these other uses. To learn more, talk with your doctor.

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Botox Bladder Treatment For Bladder Incontinence

Your doctor will review your medical history and perform a physical examination to rule out other conditions that might cause urinary incontinence, such as , bladder infection, or .

If you are a candidate for Botox bladder treatment, the procedure will be done on an outpatient basis. You do not need anyone to drive you to and from the procedure and there is no advance preparation needed. When you arrive for your appointment, you will have a urine check to ensure there is no active infection . If there is no infection, you will receive medication to numb the bladder and urethra. You will then be asked to sit for 20 to 30 minutes to allow the anesthesia to take effect.

To begin the procedure a tiny tube with a camera is inserted through the urethra, the natural opening where urine comes out. A needle is passed through and into the bladder where a series of small injections are made. The numbing medication prevents you from feeling pain although you may feel some discomfort. The injection part of the procedure takes approximately four minutes.

In clinical trials, the majority of patients receiving Botox had at least a 50 percent reduction in leakage. Approximately one in four participants reported their leakage episodes stopped completely.1

Keep in mind that it may take several weeks for the medication to calm the bladder down and to experience relief from incontinence.

Dosage For Chronic Migraine

Can Urinary Incontinence Cause UTIs? Short answer

The recommended dosage of Botox for chronic migraine is 155 units. This total dose is given as 31 injections of 5 units each. The injections are given into recommended injection sites, which are described in the How Botox is given section above.

Botox treatment for chronic migraine is typically repeated once every 12 weeks.

Note: To learn more about chronic migraine, see the Botox for chronic migraine section above.

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Bladder Botox: A Life

Mon 11, Sep 2017

Suitable for all over active bladders

May cause urine retention

There is no bowel benefit

60-70% will need repeat treatment

If it fails, its recommended you wait 36 months for alternative treatment

Temporary 6-12 month effect

Not suitable for patients with neuromuscular disease


Michelle’s Story

After ten years of sleepless nights and embarrassing bladder accidents, Michelle who lives with Multiple Sclerosis found a life changing treatment – Botox. She speaks to Jodie Harrison.

Botox, the paralysing drug, more commonly associated with ironing out facial wrinkles, has become a life-changer for tens of thousands of Australians who suffer from overactive bladder conditions.

Since 2014, Botox has been available on the Pharmaceutical Benefits Scheme up to twice a year for people who have more than 14 incontinence episodes per week and have failed more conventional treatments.

After more than a decade of embarrassing accidents, Michelle, a 47-year-old South Australian woman, told Bridge that Botox has changed her life.

Michelle has struggled with severe bladder incontinence since being diagnosed with Multiple Sclerosis 14 years ago.

I was fed up with going to the toilet all the time and wetting my pants and feeling dirty. I would change my heavy duty incontinence pants five to six times a day. I needed to get up around six times during the night, said Michelle who was advised to stop drinking fluids after 6pm.

How Much Does Botox Cost

The price of Botox depends on several factors. These can include your treatment plan, your insurance plan, the pharmacy you use, and your location. For estimates of how much Botox costs, visit

Currently, Botox is only available as a brand-name medication. Its not available in a generic form.

Talk with your doctor about using Botox for your bladder condition. They can help determine if Botox might be a good fit for you.

Here are some examples of questions you may want to ask your doctor:

  • Can I receive Botox injections if I have a urinary tract infection ?
  • After receiving my Botox injection, when will I see results?
  • Does Botox interact with any other medications Im taking?
  • Can I receive Botox injections for bladder problems if Im pregnant?

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