What To Expect After A Botox Injection In The Bladder
After your doctor finishes administering Botox in your bladder, they will monitor you in the office for about 30 minutes. You will be asked to empty your bladder before leaving the office and your doctor will check that no extra urine is retained when you use the restroom. Your doctor may prescribe 1-3 days of antibiotic pills to make sure you dont get an infection.
What The Treatment Involves:
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.
Dosage For Upper And Lower Limb Spasticity
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 Are Botox Bladder Treatment Risks And Side Effects
As with any medical procedure, there are some potential risks and temporary side effects. There is some risk of damage caused by passing the scope through the urethra to the bladder. There is also a risk of urinary tract infection and not being able to empty the bladder completely. Patients with difficulty emptying their bladders may need a catheter for urination for a short time period after the procedure. Patients may experience some pain or discomfort with urination for the first few days and there may be some blood in the urine. There is a very minor risk of blood clotting.
In clinical trials, only 6.5 percent of patients treated with Botox for incontinence needed to use a catheter after treatment.1
As with any Botox procedure, there is also a minor concern about the Botox spreading beyond the treated area and affecting other parts of the body. Your doctor will discuss the risks and benefits of Botox for incontinence and help you decide whether this is an appropriate treatment option for you.
But Both Have Side Effects That May Affect Your Choice Researchers Say
TUESDAY, Oct. 4, 2016 For women with bladder incontinence who havent been helped by medications or other therapies, Botox injections may help control leakage better than an implanted nerve stimulation device, a new study suggests.
However, both treatments are effective, according to doctors who treat the condition.
In a head-to-head comparison, women given Botox saw their number of daily urgency incontinent episodes decrease by four, on average, compared to three for women who received the implant, called InterStim.
Botox patients also said they had a greater reduction in symptoms and were more satisfied with the treatment, the researchers said.
Many women suffer from urgency incontinence and find inadequate relief of their problem from medications or behavioral changes, said lead researcher Dr. Cindy Amundsen. Shes a professor of obstetrics and gynecology at Duke University in Durham, N.C.
Both therapies appear to be very good options for women, Amundsen said. The differences in effectiveness between Botox and InterStim were small, but statistically significant, she added.
Urgency incontinence causes a strong, sudden need to urinate, according to the U.S. National Institutes of Health. The condition is also called overactive bladder. Urgency incontinence is common. The problem affects about 17 percent of women over 45, and 27 percent of women over 75, the study authors noted.
These side effects didnt really influence how patients thought about Botox, she said.
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A Team Approach To Care Botox For Urinary Incontinence
Many patients who suffer from bladder leakage as a result of overactive bladder muscles are able to regain control once again thanks to the temporary muscle relaxing effects of Botulinum A toxin.
When administered by a board-certified urologist, Botox can help patients overcome the embarrassment, inconvenience, and health risks of urge urinary incontinence with just a series of injections. The team at Comprehensive Urology are highly trained and experienced in female urinary incontinence treatment with the latest and most effective treatment options available and strive to help each and every patient find the control, independence, and confidence they deserve once again.
What Is Botox And How Does It Work
Botox® is a pharmaceutical preparation of the botulinum toxin type A produced by the bacterium Clostridium botulinum, which has muscle relaxant properties. It is usually used in MS for two reasons.
The first reason is for the relief of focal muscle spasticity and is usually used in conjunction with stretching and physiotherapy.
The second reason Botox is helpful in MS, is for the treatment of urinary incontinence due to overactivity of the detrusor muscle in the bladder. There are strict criteria to guide selection of the most suitable patients for this procedure, where clinical trials have shown significant improvements in quality of life and incontinence episodes.
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Is Botox For Urinary Incontinence Safe
There are many studies that support the efficacy and safety of Botox in the treatment of urinary symptoms regardless of the underlying cause.
Some of the potential complications of Botox include, but are not limited to, injury to the bowels, damage to the bladder, blood in the urine, and urinary tract infections . After injections, patients may experience pain with urination or temporary urinary urgency. In addition, about 25% of patients will get urinary retention, which is the inability of the bladder to fully empty on its own. If urinary retention occurs, patients may need to use temporary catheter placement or intermittent catheterization until the bladder recovers its strength. While rare, Botox can potentially be absorbed into the bloodstream, causing a loss of sensation or numbness.
As a rule, Botox should not be used in patients who have a known allergy to botulinum toxin. At the same time, patients who are allergic to any of the inactive components of Botox should refrain from using it. In general, Botox is only intended for adult patients of more than 18 years of age . Due to the lack of scientific literature on the topic, Botox should not be injected in pregnant and breastfeeding women unless it is medically justified to use the injections.
Talk to your doctor about whether Botox for incontinence is right for you.
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.
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Comparing Bladder Botox To Similar Treatments
Botox can have multiple benefits for overactive bladder or incontinence. This can be the ideal treatment for people of all ages. For older patients, this may be preferable to surgery since it will take less of a toll on the body.
Botox injections for the bladder are comparable in cost with most insurance coverages for oral medications, InterStim or percutaneous tibial nerve stimulation .
Below we highlight the pros and cons of Botox compared to other treatment options.
How Does Botox Treat Bladder Problems
Botox treats certain bladder problems in adults and in children. To learn more about the specific conditions its used for, see the What are the bladder conditions Botox treats? section above.
Botox isnt a first-choice medication for treating bladder problems. Its used when anticholinergic drugs didnt work well enough for someones condition.
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How To Take Botox
Your healthcare provider will prescribe your exact dose of Botox and tell you how often it should be given. A few things to keep in mind while taking Botox:
- A healthcare provider gives this medicine as a shot under your skin or into a muscle.
- You may be given medicine to numb the injection site.
- If you receive Botox around your eyes, you may be given eye drops or ointment to numb the area. After your injection, you may need to wear a protective contact lens or an eye patch.
- If you are being treated for bladder problems, you may also receive medicine to help prevent urinary tract infections before, during, or after treatment with Botox.
- If you are being treated for excessive sweating, shave your underarms but do not use deodorant for 24 hours before your injection. Avoid exercise, hot foods or liquids, or anything else that could make you sweat for 30 minutes before your injection.
- The recommended treatment schedule for chronic migraine is every 12 weeks.
- Botox starts working slowly. Once your condition has improved, the medicine will last about three months. Then, the effects will slowly go away. You might need more injections to treat your condition.
Who Should Undergo Botox Bladder Injections
Although Botox for the bladder is effective in treating incontinence, it is not recommended for everyone. The ideal candidates are female urology patients who do not show successful results from other treatments such as antispasmodic medication or fluid intake and pelvic floor exercises.
Patients would first need to undergo such steps or medication before a urologist allows them to receive Botox injections. For the best results, patients should receive more injections roughly every six months.
What Is Botulinum Toxin
Botulinum toxin is a natural, purified protein, which has the ability to relax the muscle into which it is injected. Botulinum toxin type A is produced by a bacteria similar to the way that penicillin is produced by a mould.
While there are many different types and brands of Botulinum toxin, Botox® is the brand that has been most widely researched for use in the urinary tract.
Botulinum toxin has been widely and safely used for over 20 years in other conditions such as the treatment of squint, muscle spasm, recurrent migraines and more recently by cosmetic surgeons in the treatment of facial wrinkles.
Botox Injections For Pelvic Floor Disorders At A Glance:
- 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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What Are Botoxs Mild Side Effects
The mild side effects of Botox can vary depending on the condition its being used to treat. Some side effects also differ between adults and children using the drug.
Mild side effects reported in people using Botox for overactive bladder symptoms include:
- trouble urinating, or pain or discomfort while urinating
- urinary retention
Mild side effects reported in people using Botox for detrusor overactivity* linked with a neurological condition include:
- urinary retention
Mild side effects reported in children using Botox for detrusor overactivity linked with a neurological condition include:
- bacteria in the urine
- leukocytes in the urine
In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage, too. But if side effects last for a longer time, or if they bother you or become severe, talk with your doctor or pharmacist.
* This refers to overactivity of the detrusor muscle, which is the muscle that lines the bladder.
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 GoodRx.com.
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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How Does Botox Treat Urinary Incontinence
Botox has been used to treat urinary incontinence for many years. It acts to decrease the muscular contractions of the bladder. These bladder spasms can arise from routine overactive bladder, which commonly occurs in women with aging or they can be more serious in patients with neurogenic bladder from neurologic disease or injury.
Bladder spasticity has a lot of different names it is also called overactive bladder, detrusor overactivity, detrusor hyperreflexia, and neurogenic bladder.
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.
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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.
Are There Any Long
In general, you may have side effects within the first week of receiving Botox injections. Most of the time, these side effects are temporary, but sometimes, side effects can last for several months or longer.
But possible long-term side effects of Botox can include:
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Side Effects In Few Patients
The main side effect of the procedure, which occurs in about 5 to 8% of patients, is urinary retention, or problems emptying ones bladder.
Those patients may need temporary catheterization to guard against an increased risk of urinary tract infections, Dr. Vasavada says. And for that reason, some patients decide against the procedure.
We just cant predict whos likely to go into retention, he says. Its not a high likelihood, but not zero, either. We still have no direct ability to predict.
But most patients havent had that hesitancy, Dr. Vasavada says. Since its been approved for incontinence, its certainly generating more enthusiasm and interest, he says.
What Are The Risks Of Botox
Botox is clinically proven to be effective at treating the symptoms of overactive bladder and other causes of urinary incontinence in women however, as with any medical procedure, there is a degree of risk. Fortunately, the side effects of bladder Botox are rare and relatively minor, but may include:
- Difficulty completely emptying bladder
- Use of catheter during the first few weeks to fully empty bladder
- Increased risk of infection
While these risks are rare, it is important to only undergo female urinary incontinence treatment from a highly experienced urologist who is experienced at treating urological issues.
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How Long Does Botox Take To Work
Botox starts to work slowly, and the time it takes Botox to work may be different for everyone. Generally:
- Muscle spasms in the eyelids should improve within three to 10 days.
- Eye muscle problems should improve one or two days after the injection, lasting for two to six weeks.
- Neck pain should improve within two to six weeks.
- Arm stiffness should improve within four to six weeks.
Who Is Not Eligible
Botox bladder injections are not recommended for patients who suffer from certain neuromuscular diseases, such as myasthenia gravis, or are currently undergoing treatments that block the neuromuscular junction, which may result in widespread or prolonged muscle weakness. The injections are also not beneficial for patients who suffer from stress urinary incontinence or cannot empty their bladder on their own. Patients who are currently suffering from a urinary tract infection will have to wait until the infection has fully cleared before undergoing the Botox procedure for urge urinary incontinence.
If you are a patient struggling with controlling your bladder on a daily basis and lifestyle adjustments or medication havenât been effective, you may find the relief you need from urinary incontinence with the InterStim system. InterStim is a medical device used for sacral nerve stimulation, which allows you to control your bladder function more effectively. The InterStim system has been approved by the U.S. Food and Drug Administration because it has helped millions of patients across the world.
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