Botox Bladder Injections
Patient Instructions
1. Read the information sheets carefully. There may be questions
you may want to ask before you are given the treatment.
2. Before you come for the Botox treatment, please fill in the
questionnaire and the frequency volume chart. These must be
given to the doctor on the day of the procedure.
3. If you are taking warfarin or clopidogrel tablets, please contact
us as these may have to be stopped for a time before the
procedure.
4. The Botox treatment is given under local anaesthetic, so you can
eat and drink as normal. You will not usually need to stay in
hospital overnight.
5. There is often a trace of blood in the urine after Botox injections. It
is also common to have some discomfort passing urine for a few
hours. Drinking plenty of fluids after the procedure can help this to
settle quickly.
If you need any further information about the procedure
please do not hesitate to ask
Patient Information Sheet
What is Botox?
Botox (Botulinum toxin) is a toxin produced by a bacterium called Clostridium
botulinum. Injection of Botox into a muscle causes temporary paralysis, so the
muscle can no longer contract properly until the Botox wears off.
The cosmetic use of Botox to temporarily improve the appearance of frown lines is
well known. More recently it has been used for a variety of medical applications
including muscle spasms, prostate disorders and overactive bladder.
Bladder Injections with Botox
Injections of Botox into the bladder muscle prevent the bladder from contracting as
strongly. If you have an overactive bladder muscle, Botox injections may reduce your
bladder contractions, allowing you to hold on for longer.
Why has my doctor recommended Botox injections?
Overactive bladder symptoms often respond to bladder training exercises, tablets
and changes to the amount and type of fluids you drink. Patients who have not
improved after trying these treatments may be offered Botox injections.
Stress incontinence (the leakage of urine when you cough, laugh or exert yourself) is
not treated in the same way and will not improve with Botox injections.
How is the Botox injected into my bladder?
First, some local anaesthetic gel is applied to the water-pipe (urethra) to make the
procedure more comfortable. A fine instrument called a flexible cystoscope is then
passed through the urethra into the bladder and the bladder is filled with fluid.
Around 20-30 small Botox injections are then given around the bladder using the
cystoscope. The injections are usually not painful, although some people experience
some discomfort. The procedure will take approximately 20 minutes.
How long will the benefits last?
Around 80% of patients will experience an improvement in their bladder symptoms.
Botox injections can take up to 2 weeks to take effect. The beneficial effects last
approximately 9 months. Repeated injections of Botox can be given once the effects
have worn off.
Are there any possible side effects?
Before having the injections, you must be sure that Botox injections are right for you.
There are a number of potential side-effects to Botox treatment and it is important
that you understand about these before you make up your mind.
The most important side effects are:
Blood in the urine
It is common to get a trace of blood for a day or two after the injections.

Urine infection
It is common to experience some burning immediately after the procedure.
Occasionally patients develop a urine infection that requires antibiotics from
their GP.

Difficulty emptying the bladder
After Botox, around 20% of patients have difficulty emptying their bladder
completely when they go to the toilet. This can sometimes cause recurrent
urine infections. A small number of patients are unable to pass urine at all.
If this happens, you may need a catheter (drainage tube) to empty your
bladder or you may need to learn to self catheterise (pass a temporary
catheter to empty the bladder several times a day). This will need to continue
until the Botox wears off (approximately 9 months).

Generalised weakness
This is a rare complication. If you notice generalised muscle weakness after
Botox injections, please contact your doctor immediately. Patients with
Myasthenia Gravis should not use Botox treatments.
If you are unsure about any of the side-effects or have any
queries about the treatment at all, you must ask the doctor
before going ahead with the treatment