Botox for Overactive Bladder
Overactive bladder is an extremely common medical condition. Upwards of 30% of men and 40% of women are thought to suffer from symptoms. These numbers may also be low estimates as people are less likely to report overactive bladder symptoms. Unfortunately, overactive bladder symptoms can be disabling and impact your daily life. For example, you may wake frequently to urinate overnight, which impacts sleep. You may have the urge to urinate frequently, which can make social occasions difficult. You may also suffer from urinary incontinence, which can be embarrassing to discuss with family and friends. Due to these symptoms, Botox for overactive bladder may be used as a treatment option.
Overactive bladder is typically treated with lifestyle changes, such as reducing caffeine and irritating foods, as well as performing exercises to improve the strength of the bladder. Prescription medications may also be prescribed.
When first-line treatment modalities fail, Botox is often recommended.
What is Botox?
Botox is a medication that is made from the bacterium Clostridium botulinim. Clostridium botulinim is the same bacteria that causes botulism, a life-threatening form of food poisoning.
As scary as that sounds, in very small doses, Botox is highly effective in treating a variety of medical conditions:
- Severe underarm sweating.
- Chronic migraines.
- Strabismus (misaligned eyes).
- Blepharospasm (uncontrollable blinking).
- Cervical dystonia (severe neck and shoulder contractions).
- Overactive bladder.
It is also highly effective in smoothing wrinkles – probably one of its most popular uses! Botox works by temporarily weakening or paralyzing muscles, as well as blocking certain nerves.
How Does Botox for Overactive Bladder Work?
Overactive bladder is characterized by symptoms like urinary frequency, urinary urgency and sometimes even urinary incontinence. To combat these symptoms, Botox is administered into the thick muscles of the bladder. These muscles are typically responsible for overactive bladder symptoms because they contribute to urinary obstruction and overactivity.
The ultimate goal is to reduce urinary urgency, urinary frequency and urinary incontinence. This is done when other treatment modalities have failed.
However, according to UCLA Health, “Approximately 70-75% of patients experience significant reduction in symptoms and improvement in quality of life.”
What Can I Expect When Getting Botox for Overactive Bladder?
When receiving Botox for overactive bladder, you can expect to receive 100 to 200 units.
The procedure is typically performed in your healthcare provider’s office. It involves a local anesthetic, typically lidocaine. Lidocaine is placed into the bladder. This is allowed to sit in the bladder for 20 to 30 minutes, which helps to numb the bladder lining.
Hormone levels can affect the body's muscles, including the bladder muscles. So, can hormones cause overactive bladder? Find out here.
Once the bladder is sufficiently numbed, a cystoscope is inserted. Botox is then injected into the bladder in various locations, using needles so tiny that they fit through the cystoscope. This portion of the procedure lasts approximately 10 minutes, meaning that the entire procedure lasts approximately 30 to 40 minutes.
Prior to the procedure, your healthcare provider may recommend the following:
- Cessation of blood thinners for one week prior to the procedure.
- Starting antibiotics two days before and continuing them for an additional two days.
You can expect the following after the procedure:
- Blood-tinged urine, pelvic pain and burning with urination may occur for a day or two.
- Difficulty with voiding, which may require self-catheterization.
- A urinalysis and check of post-void residual volume, which is scheduled for two weeks after the procedure.
It can take one to two weeks to note improvement in symptoms, and can last for six to nine months; the dosage can be increased with the next procedure if improvement in symptoms wears off early or is only partially effective.
Are There Any Side Effects of Botox for Overactive Bladder?
Side effects are unlikely, but as with any medication, they are a possibility.
The most common side effect is an increase in post-void residual, which means that the bladder is left with urine after going to the bathroom. Typically, this is not a problem. However, in about 6% of people during clinical trials, temporary catheterization was required. When this occurs, the person is instructed on how to self-catheterize and may be required to perform this procedure one to four times per day. In this small population, self-catheterization was required for two to six weeks.
The other side effects are blood in the urine and urinary tract infections. Urinary tract infections can occur with or without self-catherization.
The Bottom Line…
Though it can be frustrating when first-line treatments fail, Botox is typically extremely effective in treating overactive bladder symptoms.