Overactive bladder (OAB) is a group of symptoms that makes a person feel like they need to urinate urgently and often. It is not a disease.

Symptoms of OAB can include:

  • feeling a sudden, intense urge to urinate
  • leaking urine when experiencing this urge
  • passing urine frequently throughout the day and night

There are several treatments for OAB, including Botox injections directly into the bladder.

This article discusses how Botox for OAB works, what to expect during and after the procedure, and more.

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Botox is a drug belonging to the neurotoxin drug class. It is made from the bacteria that cause botulism, Clostridium botulinum.

These bacteria exist harmlessly in natural settings such as soil, wetlands, and the gastrointestinal tracts of some animals. When the bacteria mutate and the population rises, the bacteria may begin making the extremely dangerous Botulinum toxin, which causes botulism. Botulism can lead to paralysis and death.

Scientists took into consideration the potential uses for the toxin’s paralyzing effect. As a result, Botox injections use very small amounts of the Botulinum toxin to therapeutically paralyze muscles. A medical professional will inject the Botox directly into the muscle they target.

Many people associate Botox with cosmetic uses such as smoothing facial wrinkles, but its effects on other muscles can help treat people with certain medical disorders, including OAB.

Research indicates Botox disrupts the neurotransmitters in the muscles of the bladder and inhibits certain sensations that would cause a person to need to urinate. It also has anti-inflammatory effects.

While doctors do not recommend Botox in the bladder as the first line of treatment for OAB and other bladder problems, it is a viable, proven option if lifestyle changes and medications do not prove successful in providing relief from symptoms.

A medical professional will inject Botox directly into the muscle of the bladder wall to relax it. This can prevent the bladder muscles from squeezing too often or too intensely, which reduces urinary urgency and frequency.

Some people who receive Botox injections for OAB may experience side effects, including an increase in the amount of urine left in the bladder after voiding. This is known as residual urine.

Some people may also be unable to void at all or have difficulty starting to urinate, known as hesitancy. This can indicate a person has urinary retention, which can cause severe pain.

In some cases, a person may require catheterization to relieve urinary retention. A 2017 study on women receiving Botox for OAB showed 6% of the study participants needed catheterization due to severe urinary retention. The same study notes that other data shows between 2–31.8% of people will need catheterization after the procedure.

According to the study, new-onset urinary retention due to the procedure may happen anytime within the first 2 weeks following the injection.

Some people may also develop a urinary tract infection or experience blood in the urine.

Botox for OAB is generally an outpatient procedure performed under local anesthesia. The appointment will begin with a medical professional inserting a catheter into the bladder through the urethra.

A person will then receive a local anesthetic such as lidocaine through the catheter. The numbing agent will remain in the bladder for up to 30 minutes before the Botox injections.

A doctor will then pass a small scope connected to a camera into the bladder through the urethra. This device administers a series of injections of Botox solution into the muscle of the bladder with a small needle that is passed through the scope.

The actual series of injections is very quick.

Most people tolerate bladder Botox injections well. A person can often go home shortly after the treatment when performed under local anesthesia or within 2–3 hours following treatment under general anesthesia. Individuals should experience results from the injections within 2 weeks of the procedure.

A person will require repeat treatment when their OAB symptoms return. Results are effective for at least 3 months but can last between 6–12 months.

Botox can be an affordable treatment option for OAB though costs can vary.

Most health insurance covers Botox treatments that the Food and Drug Administration (FDA) has approved for medical reasons.

A person can check with their insurance to see what it will cover.

People who think they may have OAB can start by talking with a doctor.

A doctor should be able to recommend a urologist or a urogynecologist that can treat OAB. Some urologists or urogynecologists specialize in treating OAB.

Botox injections for OAB can help alleviate symptoms when other treatments and lifestyle changes have not worked.

While the treatment is effective, a person will require repeat injections to maintain the effects.