Botulinum Toxin Injections

Botulinum Toxin (sometimes known as BOTOX®) is a medicine injected into the bladder to treat overactive urinary symptoms such as urgency and frequency where other types of medicines such as anticholinergics have failed. Botulinum Toxin is used to relax the bladder muscle thereby reducing the need to visit the toilet as urgently and frequently as before.

Botulinum Toxin is injected into the bladder through a cystoscopy. This procedure is performed as a day case.

Points to note

  • Due to risk of urinary retention, only patients who are able to catheterise following treatment are considered.
  • All patients must be infection free. A urine culture is required one week before your procedure. Your doctor and Practice Nurse will follow up the results and will arrange antibiotics if required (Please call the inform the Practice Nurse when the urine culture was obtained and taken to pathology – this will ensure correct follow up).
  • Generalised weakness may sometimes occur. This is not a concerns and usually resolves.
  • The effects of botulinum toxin will not be noticed for 7-14 days following injection. Therefore, do not be alarmed if there is no improvement in your urinary symptoms in the first two weeks
  • The long term effects of botulinum toxin varies between person to person but generally will last between 6-9 months. For some patients, this may be longer.

Following surgery

  • You will be monitored before discharge to ensure you are able to empty your bladder efficiently.
  • If you feel your bladder hasn’t emptied completely then double void may be helpful. This means, try again approximately 30 seconds later.
  • You may notice slight blood in your urine for a few days following injection. This is normal and it is important to ensure you drink adequate fluids.
  • You will return to the rooms approximately 2 weeks following injection to monitor your progress. Please call the rooms and arrange an appointment if the hospital has not done so.
  • It is important to arrange repeat injection before your symptoms return completely.

You must call the rooms if you experience any of the following:

  • Fever
  • Inability to pass urine
  • Persistent bleeding
  • Persistent pain
  • Nausea and/or vomiting
  • Signs of a urinary tract infection (offensive and cloudy urine, presence of sediment, burning/stinging when trying to pass urine, fever)