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How Does Botox Work for Bladder Control?

Botox (Botulinum A toxin) stops your nerves from telling your muscles to tighten (contract). Botox is a popular cosmetic procedure, but providers also use it to treat other medical conditions, including bladder issues. The Food and Drug Administration (FDA) approved the drug for bladder control in 2013.

Overactive bladder causes your bladder muscles to spasm without warning. When this happens, you may experience urine leakage, an urgent need to urinate, or frequent urination. You may also have trouble sleeping since you need to go to the bathroom frequently. 

Injections of Botox directly into the bladder muscle prevent the bladder from contracting. The procedure is relatively painless, quick, and requires no downtime. 

Pros & Cons of Bladder Botox

Botox treatment is a highly effective way to stop bladder spasms that cause urinary incontinence. Nearly 75% of people experience reduced symptoms and an improved quality of life. 

There are many benefits of Botox injections to the bladder: 

  • Ability to control your bladder without fear of leakage
  • Fewer trips to the bathroom during the day and night
  • Greater confidence in public settings
  • Improved sleep
  • Reduced need for urinary incontinence products like pads or briefs
  • No daily pills or medication side effects

On the other hand, you’ll need to repeat bladder Botox treatments a couple of times a year, and the medicine’s effectiveness may decrease over time. In rare cases, some people have difficulty completely emptying their bladders after Botox injections. It’s okay for some urine to remain in your bladder; however, you may need to use a catheter (small tube) to remove more significant volumes of urine.

Patient Criteria for Bladder Botox Injections

Botox injections are not the first option for treating overactive bladder. Your provider will prescribe medicine and recommend lifestyle changes as a first step. Botox may be an option for you if these initial treatments do not stop urine leakage or overactive bladder. Candidates for Botox must have the following issues: 

  • You need to urinate suddenly and cannot control the urge. 
  • You urinate eight times or more each day.
  • You wake up two or more times at night to urinate.

Before you undergo Botox treatment, we will check that you do not have an active bladder infection. We will test you with a urinalysis and urine culture a few weeks prior to the procedure.

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What to Expect During a Bladder Botox Procedure

Picture of a small instrument injecting Botox into the muscle that lines the bladder wall.

A bladder Botox treatment requires no special preparation. The procedure is completed in our clinic and takes about an hour. After the injections, you might have some blood in your urine, but you can return to your usual activities right away. 

How Do They Inject Botox into the Bladder?

To reach your bladder, your urologist passes a small instrument called a cystoscope through your urethra, the tube that drains urine from your body. Using the cystoscope, your surgeon injects between 100 and 300 units of Botox into the muscle that lines the bladder wall. The amount depends on your exact diagnosis. The appointment takes about an hour but the injection takes less than five minutes.

Anesthesia for Bladder Botox

Before the procedure, your surgeon will apply a numbing medication (local anesthetic) to your bladder so you should not feel discomfort. 

Some patients may choose to have the treatment completed in an operating room under general anesthesia. Your urologist will help you decide the approach that’s best for you.  

Bladder Botox Side Effects

After treatment, you should have no bladder pain, but you may feel a slight burning the first few times you urinate. This sensation should go away within a few days. You might also have some light blood in your urine. 

Some people develop urinary tract infections (UTIs) following injections. Your urologist may prescribe antibiotic medication to make sure you don’t get an infection.  

Long-Term Effects of Botox in the Bladder

There are no long-term side effects of bladder Botox. As long as the medication continues to treat your symptoms, you can have bladder Botox treatments every 3-12 months. For some patients, the effectiveness of the medication may decrease over time, but this is difficult to predict. 

How Quickly Does Botox Work?

Botox does not work the same day as the injection. You will see an improvement in your symptoms about a week after receiving bladder Botox injections. However, it may take up to two weeks for the medicine to become fully effective. 

How Long Does Bladder Botox Last?

Botox treatment is not permanent. You’ll need to repeat the treatment every 3-12 months depending on your bladder condition.

What if Bladder Botox Does Not Work?

If Botox injections are not effective after one treatment, your University of Utah Health urologist may recommend increasing the dosage or changing the injection technique. If bladder Botox or conservative treatments do not work, your urologist will suggest other ways to relieve overactive bladder. Other treatments we offer include neuromodulation therapy which uses mild electrical pulses to reduce bladder symptoms. See your urologist for more details.

Make an Appointment with a Urologist

Urologists at U of U Health have performed thousands of Botox injections for bladder control and treat highly complex urologic patients. 

Make an appointment with our one of our urologists, or ask your gynecologist, primary care provider, or urologist to make a referral. To make an appointment, please call 801-213-2700.