North Bay Ontario

Botox (Bladder)

Urology North

Call Us:  +1-705-995-2490

Botox (onabotulinumtoxin A) can be used to relax the bladder.  This is a fairly new and exciting treatment for neurogenic bladder disorders and overactive bladder.  This is a specialized treatment for severe cases that is not considered first line therapy.  It has recently been approved by the FDA as an indication for severe overactive bladder refractory to other treatments.

Please note: Currently Ontario Drug Benefits (ODB) only will cover Botox bladder injections for neurogenic bladder.  Cases of non-neurogenic bladder wanting this treatment may require the patient to pay for the drug out of pocket or through private insurance.  

The Procedure

Please arrive at the outpatient unit on time. You can expect to be at the hospital for a few hours; however the surgery itself will last approximately 15 minutes.  

Risks

All surgical procedures have inherent risks associated with them.  Despite these risks being very low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

Bladder botox injections are a very safe procedure, however, the risks do include anesthetic complications such as adverse drug reactions or even death.  Specific to the surgery, because of the manner in which Botox works, urinary retention and the need for a catheter to empty the bladder can occur.  Introduction of a urinary tract infection can occur.  Blood and burning with voiding are also common following the procedure.  Extremely rarely Botox can be systemically absorbed during bladder injections and can cause generalized weakness and other systemic effects.    

When you arrive

Botox injections can be performed under either a general anesthetic, regional anesthetic, or with sedation.  On arrival to the hospital you will be brought to the operative suite where you will be given an anesthetic.  Once this has been administered you will be placed into a lithotomy position to allow placement of the cystoscope into the bladder.  Through a specialized flexible needle called a "William's needle" the Botox solution will be instilled into the bladder.

After Botox Injection

After your Botox injection you will be able to resume normal activities including  heavy lifting, physical exercise, and sports within a few days.  The medication does not work immediately, and as such, there is minimal risk initially of not being able to void.  It is expected that the Botox will increase bladder capacity and reduce overactivity within 3-4 weeks.  If you have difficulty voiding at this time, please contact your urologist.  Usually Botox bladder injections provide benefit for 9-12 months initially and then will need to be repeated.

When Should I Call my Doctor?

You should contact our office if significant pain persists following the procedure, if you are having a hard time passing your urine, or if you develop a fever.  It is important to know that the medication does not begin to work for ~ 3 weeks following instillation.  As such, it is important to watch for side effects of the treatment for several weeks after instillation.  

Q&A

1. What are the success rates?

     Depending on the reason for your urologist suggesting bladder Botox injections will determine how likely it is to provide significant benefit.  This should be discussed during your consultation.    

2. Will it hurt?

     The procedure is not typically considered painful.  Patients do not require pain medication following the procedure.

3. How long will it take?

     The procedure length is usually about 15 minutes.

4.  What if I am not covered for this treatment, How much does it cost?

     Unfortunately, not all treatments that have been proven beneficial are covered.  The cost of Botox at the pharmacy is ~ 400$ for 100 units.  Most patients begin with 100 units being injected, but some require 200 units.