Botox Bladder Injections

Patient Instructions

1.  Read the information sheets carefully. There may be questions you may want to ask before you are given the treatment.

2.  Before you come for the Botox treatment, please fill in the questionnaire and the frequency volume chart. These must be given to the doctor on the day of the procedure.

3.  If you are taking warfarin or clopidogrel tablets, please contact us as these may have to be stopped for a time before the procedure.

4.  The Botox treatment is given under local anaesthetic, so you can eat and drink as normal. You will not usually need to stay in hospital overnight.

5.  There is often a trace of blood in the urine after Botox injections. It is also common to have some discomfort passing urine for a few hours. Drinking plenty of fluids after the procedure can help this to settle quickly.

If you need any further information about the procedure

please do not hesitate to ask


Patient Information Sheet

What is Botox?

Botox (Botulinum toxin) is a toxin produced by a bacterium called Clostridium

botulinum. Injection of Botox into a muscle causes temporary paralysis, so the muscle can no longer contract properly until the Botox wears off.

The cosmetic use of Botox to temporarily improve the appearance of frown lines is well known. More recently it has been used for a variety of medical applications including muscle spasms, prostate disorders and overactive bladder.

Bladder Injections with Botox

Injections of Botox into the bladder muscle prevent the bladder from contracting as strongly. If you have an overactive bladder muscle, Botox injections may reduce your bladder contractions, allowing you to hold on for longer.

Why has my doctor recommended Botox injections?

Overactive bladder symptoms often respond to bladder training exercises, tablets and changes to the amount and type of fluids you drink. Patients who have not improved after trying these treatments may be offered Botox injections.

Stress incontinence (the leakage of urine when you cough, laugh or exert yourself) is not treated in the same way and will not improve with Botox injections.

How is the Botox injected into my bladder?

First, some local anaesthetic gel is applied to the water-pipe (urethra) to make the procedure more comfortable. A fine instrument called a flexible cystoscope is then passed through the urethra into the bladder and the bladder is filled with fluid.

Around 20-30 small Botox injections are then given around the bladder using the cystoscope. The injections are usually not painful, although some people experience some discomfort. The procedure will take approximately 20 minutes.

How long will the benefits last?

Around 80% of patients will experience an improvement in their bladder symptoms. Botox injections can take up to 2 weeks to take effect. The beneficial effects last approximately 9 months. Repeated injections of Botox can be given once the effects have worn off.

Are there any possible side effects?

Before having the injections, you must be sure that Botox injections are right for you. There are a number of potential side-effects to Botox treatment and it is important that you understand about these before you make up your mind.

The most important side effects are:-

·  Blood in the urine

It is common to get a trace of blood for a day or two after the injections.

·  Urine infection

It is common to experience some burning immediately after the procedure. Occasionally patients develop a urine infection that requires antibiotics from their GP.

·  Difficulty emptying the bladder

After Botox, around 20% of patients have difficulty emptying their bladder completely when they go to the toilet. This can sometimes cause recurrent urine infections. A small number of patients are unable to pass urine at all.

If this happens, you may need a catheter (drainage tube) to empty your bladder or you may need to learn to self catheterise (pass a temporary catheter to empty the bladder several times a day). This will need to continue until the Botox wears off (approximately 9 months).

·  Generalised weakness

This is a rare complication. If you notice generalised muscle weakness after Botox injections, please contact your doctor immediately. Patients with Myasthenia Gravis should not use Botox treatments.

If you are unsure about any of the side-effects or have any queries about the treatment at all, you must ask the doctor before going ahead with the treatment