Bladder Botulinum toxin injections

What is Botulinum toxin?

Botulinum toxin has been used for many years in cosmetic surgery to reduce facial wrinkles. Botulinum toxin works by stopping the nerve signals which cause muscles to contract.

Patients with an overactive bladder or urge incontinence often have a bladder muscle which starts to squeeze at the wrong time. This causes a desperate need to pass urine (urgency) which is very uncomfortable and can result in incontinence.
Botulinum toxin injections into the bladder reduce the bladder contractions so that the bladder control improves. Botulinum toxin is not licensed for injections into the bladder, but this is a widely used treatment which has proven effectiveness.

How successful are bladder Botulinum toxin injections?

Research has shown that bladder injections using Botulinum toxin can be highly effective in reducing the symptoms of overactive bladder and urge incontinence. Around 85% of patients will have no incontinence after treatment with Botulinum toxin, and 80% of patients have a reduction in rushing to the toilet.

Some patients can have difficulty emptying their bladder after Botulinum toxin injections, which can lead to infections or other bothersome symptoms. This is usually a temporary problem, but you should discuss this with a specialist before proceeding with the injections.

How are Botulinum toxin bladder injections given?

The bladder injections can usually be done under local anaesthetic but sometimes a general anaesthetic (patient asleep) is preferred. You can normally go home the same day.

A local anaesthetic gel is applied to the urethra and a narrow telescope is then inserted into the bladder. A fine needle is used to give the injections. If you are awake, the injections can cause a little discomfort, but they aren’t usually painful. The operation takes around 20 minutes in total.

Patients often notice a little blood in the urine afterwards, but this quickly settles just by drinking plenty of water.

How long will the benefits of Botulinum toxin last?

The effects last an average of 9 months, but can last considerably longer. You can have further injections if the effects wear off.

Paying for the treatment

Bladder Botulinum toxin injection costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost will be explained and confirmed in writing when you book. Ask the hospital for a quote beforehand, and ensure that this includes all associated costs.


Author: Mr Richard Parkinson Ph.D FRCS(Urol), Consultant Urological Surgeon, BMI The Park Hospital, Nottingham

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