Botulinum Injection

BOTOX® (onabotulinumtoxinA) Important Information

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Botulinum Injection: BOTOX® for injection is indicated for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and frequency. BOTOX® (onabotulinumtoxinA) temporarily calms muscle contractions in the bladder by blocking the transmission of nerve impulses to the bladder muscle.

Candidates for Botox Treatment

The U.S. Food and Drug Administration has approved a new use for BOTOX® (onabotulinumtoxinA) to treat overactive bladder symptoms such as a strong need to urinate with leakage, urgency and frequency in adults when another type of medicine (anticholinergic) does not work well enough or cannot be taken.  BOTOX® (onabotulinumtoxinA) temporarily calms muscle contractions in the bladder by blocking the transmission of nerve impulses to the bladder muscle.

Botox is appropriate for patients who:

  • experience overactive bladder symptoms such as a strong need to urinate with leaking or wetting accidents, a strong need to urinate right away (urgency), and urinating often (frequency)
  • And are adults 18 years and older when another type of medicine (anticholinergic) does not work well enough or cannot be taken.

Botox is not appropriate for patients who:

  • Have a urinary tract infection (UTI)
  • Cannot empty their bladder on their own
  • And are not routinely catheterizing. 
  • May be allergic to any of the ingredients in BOTOX®.

Administration of Botox

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For your comfort, a local anesthetic may be administered to numb the bladder, and you may also be provided with a sedative, all of which can be performed in the doctor’s office.  Once the bladder is numb, BOTOX® (onabotulinumtoxinA) is injected into the bladder muscle using a rigid or flexible cystoscope, a specialized tube with an optical lens at the end that is used to see inside the bladder. A cystoscope is placed into the bladder via the urethra. Once the specialist is able to access the bladder and initiate the BOTOX® injections, the treatment takes approximately 15-20 minutes and then the patient is observed for approximately 30 minutes before they leave the office.  Improvements in other symptoms of overactive bladder, daily frequency of urination and the amount of urine voided may occur with BOTOX® treatment.

Side Effects

The most common side effects reported with BOTOX® treatment in the clinical studies included:  urinary tract infection, dysuria (painful or difficult urination), and urinary retention, which is a temporary inability to fully empty the bladder requiring clean intermittent catheterization.