Many have heard of Botox, but very few know the benefits Botox can have on the bladder.

1. What is bladder Botox?

Dr. Bradford Stevenson, a Urologist at Ogden Clinic, explains how bladder Botox works extremely similar to traditional Botox.

"Botox works by paralyzing the muscles of the face that are causing the wrinkles. Bladder Botox works the same way except in the bladder, we aren't trying to remove wrinkles, we are trying to eliminate unwanted bladder muscle contractions that lead to overactive bladder symptoms."

2. What is an overactive bladder?

Overactive bladder is the complaint of a sudden compelling desire to urinate that is difficult to postpone for fear of leakage. Overactive bladder can be caused by neurologic disease or nerve injury. In men, it is thought that an enlarged prostate can lead to overactive bladder symptoms. But in most cases there is not an identifiable cause. This is known as an idiopathic overactive bladder.

3. When is bladder Botox Needed?

The purpose of bladder Botox is to address the symptoms of an overactive bladder. Treatment with Botox is considered if oral medication fails to adequately control symptoms, or if there are undesirable side effects from the medications. Symptoms can range in severity that Dr. Stevenson describes below.

• Moderate: Having frequent and inconvenient urinary needs throughout the day and night.
• Severe: Urinary urgency that forces one to immediately run to the bathroom when the urge hits.
• Extreme: Actual urinary leakage can occur before one can make it to the bathroom.

4. Who is most prone to an overactive bladder?

The prevalence of overactive bladder increases with age. It is most common in people over 60 years old, but it can be present in any age group. Overactive bladder symptoms are equally as common in women and men, but overactive bladder with urinary incontinence is much more common in women due to a weaker bladder neck and sphincter, especially in women who have had children.

5. The actual procedure

The in-office procedure requires no incisions. First, the bladder is flushed with a local anesthesia through a catheter. Next, a scope is passed through the urinary channel or urethra and inserted into the bladder. At this point, several injections are given in the bladder in order to spread the Botox. Dr. Stevenson emphasizes the noninvasive nature of the procedure leads to a speedy recovery.

"A patient can expect to go back to regular activity after the procedure. There are no restrictions," he says.

6. How well does it work?

The Botox will begin to work within one week of the procedure but may take up to two weeks before the full effect is felt. It is important to remember that Botox wears off in 6-12 months, after which the injections will need to be repeated. Patients are advised to wait a minimum of 12 weeks between each injection.

Dr. Stevenson says that in some cases, patients have improved symptoms after the Botox has worn off. He acknowledges there is no guaranteed cure for incontinence but believes bladder Botox is one of the best procedures to deal with it if medications are not working.

"Even if the Botox procedure doesn't completely cure incontinence, the majority of patients do see improvement in their symptoms," he said.

7. What are the side effects?

Possible side effects that can be caused by treating an overactive bladder with Botox include:

• Urinary tract infection
• Urinary retention
• Hematuria
• Burning with urination

"If the bladder muscle gets over paralyzed, the patient will have difficulty emptying their bladder and may need to empty their bladder through a catheter until the effects of the Botox wear off," he says. Dr. Stevenson says that the risk of developing a urinary tract infection can usually be addressed through medication given at the time of the procedure. He reminds potential patients that the use of Botox for an overactive bladder has been around since 2010 and is FDA approved.

8. Summary

An overactive bladder can be embarrassing and disruptive to one's lifestyle. The bladder Botox procedure is a well-tolerated treatment that helps to treat all levels of overactive bladder. There is no limitation to the duration of using Botox. Dr. Stevenson says the majority of insurance plans cover bladder Botox injections. He adds, "For patients who feel their bladder issues control their life, Botox can give them their life back."

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