Botulinum toxin is widely known by one of its trade names, Botox. It is a strong toxic substance which is used in cosmetic surgery and for medical purposes. For overactive bladder (OAB) symptoms, botulinum toxin is injected into the lining of the bladder to reduce the activity of the nerves involved in the symptoms. This treatment may improve the symptoms of urgency, frequency of urinating, and urgency incontinence.
Botulinum toxin injection
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 several 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. You also may present a urinary tract infection after botulinum toxin treatment and may need to get antibiotics prescribed.