Botox is a powerful drug that is injected into the bladder muscle to help reduce involuntary urine loss. It is administered through a cystoscope, with a series of rapid injections into specific areas of the bladder. It may take between 24 and 72 hours for the Botox to take effect, but in rare cases it can take longer. Approximately 6 out of 100 patients need a catheter after treatment.
Most people experience a reduction in their HAV symptoms within two weeks of the first Botox injection, and the full effects are usually seen at 12 weeks. Botox in the bladder typically lasts for six months, after which time you can schedule an appointment to have it redone. Botox takes time to work effectively, but most people will notice some relief from their HAV symptoms within two weeks of the first injection. The full effect of the drug may take up to two weeks to be seen. Botox is not permanent and lasts for six to eight months in the bladder. It has a prolonged effect on the bladder compared to other muscles, where it can last only a few months.
There are two side effects associated with injecting Botox into the bladder. The first is an increase in post-voiding residue, or the amount of urine left in the bladder after urination. In most cases, this does not cause any symptoms and does not need treatment. However, in some patients (about 6% in clinical trials) it may be a problem and may require temporary use of a catheter to help empty the bladder. When this occurs, patients are taught to undergo catheterization one to several times a day due to problems associated with increased post-micturition residues, such as a complete inability to urinate (urinary retention).
In the small number of people in whom this occurs, the need for catheterization usually lasts 2 to 6 weeks. Other side effects include bleeding in the urine or a urinary tract infection that can occur with or without an elevated residue after urination. Botox is approved by the FDA in the United States at a dose of 100 units for HAV and 200 units for HAV associated with neurological conditions. This waiting period allows the doctor to make sure that you tolerate Botox and that there were no problems with the injection. The goal of Botox in the bladder is to effectively treat persistent and disabling urinary incontinence with urgency, frequency and urgency. Botox is generally used to improve conditions with muscle spasticity, involuntary muscle contractions, excessive sweating, and twitching of the eyelid or eye muscles. When looking for a doctor near you who gives injections of Botox into your bladder, make sure they are board certified and specialize in this area of interest. After using anesthesia to numb the bladder, the urologist will make small injections into the wall of the bladder, where the bladder muscle is located.
You don't need general anesthesia for Botox injections into the bladder, but your doctor will give you a local anesthetic to temporarily numb your bladder so you don't feel any discomfort during the injections - similar to how a dentist numbs your mouth before filling a cavity. Because Botox injections into the bladder do not require general anesthesia, you can go back and forth from treatment. When Botox is injected into the bladder muscle, it treats thick muscle bands known as trabeculation. The study found that after just one month, a higher percentage of women who received Botox injections reported that their urinary incontinence symptoms were under control.
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