Botulinum toxin is widely known by one of its trade names, Botox® and is often used in cosmetic surgery.
For OAB symptoms, the toxin is injected into the lining of the bladder to reduce the activity of the nerves which cause the symptoms. This treatment may improve urgency, frequency of urinating, and urgency incontinence.
For botulinum toxin injections, you will generally receive local anaesthesia. Sometimes other forms of anaesthesia are used. The doctor uses a type of endoscope, known as a cystoscope, to enter your bladder through the urethra. The cystoscope has a small camera to show a high-quality image of your bladder on a video monitor. The doctor injects a small dose of botulinum toxin into different areas of your bladder wall (Fig. 1).
The effect of the procedure will wear off with time and after 4-9 months you will need to undergo repeat treatment. Some people (less than 10%) may have difficulty urinating after a botulinum toxin injection, and may need a catheter. Catheters may increase the risk of urinary tract infection and your doctor may prescribe antibiotics.