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Using Botox in Bladder for Urinary Symptoms and Incontinence

By Stacey Gazan, ARNP and Alejandro Miranda-Sousa, MD

Using Botox in Bladder for Urinary  Symptoms and IncontinenceWhat Is OAB?
Overactive Bladder (OAB) is a condition where the bladder contracts uncontrollably, creating leakage, the strong sudden need to “go right away,” and going too often. OAB is caused by:
• Nerves signal that your bladder is full too soon
• Your muscles contract when your bladder is still filling
• You experience a sudden urge to go
• Urine is forced out, especially if your muscles are weak

What are the Symptoms of OAB?
OAB symptoms include:
• A sudden urge to urinate that is difficult to control
• An accidental loss of urine immediately following an urgent need to go
• The need to urinate frequently, usually 8 or more times within a 24-hour period
• Not making it to the bathroom on time
• The need to urinate two or more times a night

Medications for OAB
We may try many different medications to calm the overactivity of the bladder. Medications can block the nerves that signal your bladder to contract too soon. These medications can also help relax the smooth muscle that surrounds your bladder so your bladder holds more urine. Examples of these medications include: Oxybutynin, Toviaz, Vesicare, Detrol, and Myrbetriq.

Alternatives when your OAB does not improve with medications
BOTOX is a prescription medicine, FDA approved, that is injected into the bladder muscle and used:
• To treat overactive bladder symptoms such as a strong need to urinate with leakage or wetting accidents; urgency and frequency in adults when another type of medication (anticholinergic) does not work well enough or cannot be taken.

• To treat leakage of urine (incontinence) in adults, with overactive bladder due to neurologic condition, who still have leakage or cannot tolerate the side effects after trying an anticholinergic medication.

The American Urological Association (AUA) treatment guidelines list BOTOX as an appropriate therapy to consider discussing with your doctor when:

Self-management is not effective (for example, using pads, or drinking less liquids).

Oral medications do not work well enough or are too difficult to tolerate.

How Is BOTOX given
Patients undergo a cystoscopy (insertion of a lighted scope into the bladder) in the office under local anesthesia and BOTOX is injected into the bladder muscle through the scope, where it helps block the nerve signals that trigger OAB. This can significantly reduce daily leakage episodes by half or more. BOTOX also treats the strong need to urinate right away and often reduces the number of times you need to empty your bladder each day.

BOTOX is often covered by insurance and is often tolerated better than medication alone. Side effects are not common.

To make an appointment, please call
239-226-2727, or visit their website at

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