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Bladder Botulinum Toxin (Botox) Injection

Injection of botulinum toxin into the bladder muscle in overactive or neurogenic bladder.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Bladder Botulinum Toxin (Botox) Injection?

Bladder botulinum toxin (onabotulinumtoxinA, Botox) injection consists of cystoscopic delivery of botox into the bladder muscle (detrusor) for overactive bladder (OAB) or neurogenic detrusor overactivity.

The procedure can be performed in an outpatient setting under local anesthesia using a cystoscope. Injections are made into 20-30 different sites in the bladder wall. The dose is 100 units in OAB and 200-300 units in neurogenic bladder.

The effect begins within one to two weeks and lasts for 6-12 months. It is used as a second-line therapy in patients who do not respond to anticholinergic agents or cannot tolerate their side effects. Repeated injections are safe.

Symptoms

Sudden urgency
Urgency-type urinary incontinence (urge incontinence)
Frequent urination (more than 8 times per day)
Frequent night-time urination (nocturia)
Insufficient response to anticholinergic medication
Neurogenic detrusor overactivity (multiple sclerosis, spinal cord injury)

Risk Factors

Risk of urinary retention (5-10%, transient)
Risk of urinary infection
Muscle weakness (in patients with neuromuscular disease)
Anticoagulant therapy (risk of hematuria)
Pregnancy (contraindication)
Active urinary infection

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When anticholinergic and beta-3 agonist medications are not sufficient
  • When medication side effects (dry mouth, constipation) cannot be tolerated
  • High-pressure detrusor contractions in neurogenic bladder
  • Inability to urinate after botox injection

Treatment Methods

01
Cystoscopic detrusor botox injection (OAB: 100 U, neurogenic: 200 U)
02
Trigone-sparing injection technique
03
Local anesthesia (intravesical lidocaine instillation)
04
Repeat injection (when effect wanes, every 6-12 months)
05
Post-injection post-void residual monitoring (PVR)
06
Temporary clean intermittent catheterization (in case of retention)

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.