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Urologic Conditions & Treatments

Botulinum Toxin Chattanooga TN

Botulinum Toxin OAB TNFor some patients, the urinary frequency, urgency and leakage of Overactive Bladder (OAB) may not be fully controlled with medications. Other patients may have intolerable side effects or may have other medical conditions that limit the usefulness of medications for OAB. For these patients, certain other OAB therapies, often called Advanced Therapies, may be appropriate treatment for OAB.

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What is an overactive bladder?

Overactive bladder causes a frequent and sudden urge to urinate that the person may not be able to control. The condition makes the person feel as if they need to pass urine many times during the day and night. There may be urinary incontinence, the involuntary loss of urine. Urinary incontinence can be an embarrassing problem, leading the person to avoid social situations.

What causes an overactive bladder?

In normal function, as the bladder fills it sends nerve signals to the brain of the upcoming need to urinate. The brain will then coordinates the relaxation of the pelvic floor muscles and the muscles that control the urethra. Then the muscles of the bladder contract and push the urine out.

When a person has overactive bladder the muscles of the bladder start to contract involuntarily even when the volume of urine in the bladder is low. These involuntary bladder contractions create the feeling of a need to urinate.

Several conditions can be associated with an overactive bladder:

  • Neurological disorders, such as multiple sclerosis or a stroke
  • Diabetes
  • Urinary tract infections that create similar symptoms
  • Hormonal changes during menopause in women
  • Abnormalities in the bladder, such as bladder stones or a tumor
  • Factors that obstruct bladder outflow, such as an enlarged prostrate, constipation, or previous operations to treat other forms of incontinence

Other factors can also be involved:

  • Medications that cause a rapid increase in urine production
  • Declining cognitive function with aging, clouding communication between the brain and the bladder
  • Walking difficulty, making it difficult to get to the bathroom in time
  • Incomplete bladder emptying

How does Botox Help With An Overactive Bladder?

Small amounts of botulinum toxin may be injected into wall of the bladder, through a special scope (called a cystoscope), to control the urinary frequency, urgency and leakage of OAB. Injection of botulinum toxin into the bladder wall helps to block the signals from your bladder that make you feel as though you need to urinate frequently and urgently, and can help patients with urinary leakage.

What are the benefits of Botox injections for overactive bladder?

Botox is an effective treatment for overactive bladder. It enables patients to stop taking medications for their overactive bladders, many of which have unpleasant side effects. Also, most OAB medications have proven to have only mixed effectiveness.

  • Allows patients to stop taking daily OAB medications.
  • Botox only needs to be placed in the bladder about once every six months.
  • The Botox injections at UT Urology only take a few minutes.
  • Patients can reduce their daily leakage episodes by 50% or more.
  • These injections allow patients to return to normal life without worrying about leakage.
  • Botox injections can allow a patient with OAB to regain their confidence.
  • Botox injections can make social embarrassment a thing of the past.

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Who Should Consider Botox to treat Overactive Bladder?

Diagnosis of Overactive Bladder

Advanced Therapies, including botulinum toxin injection, are appropriate for patients with moderate or severe symptoms of Overactive Bladder (OAB) including urinary frequency, urgency or leakage (incontinence), who have continued bothersome symptoms after other treatments or who are not able to use other treatments.

Botulinum toxin injection into the bladder is not for everyone. Patients who would have difficulty if catheterization were needed should consider other therapies.

How is Botox Injected For Overactive Bladder Treatment?

Botulinum toxin is injected into the bladder while looking in your bladder through a small scope called a cystoscope. The injection may be done in the office or under sedation in the operating room, depending on your preference. If you choose to have the procedure in the office, a numbing medicine is put into the bladder and your urine tube (urethra) to minimize discomfort.

While looking through the scope into your bladder, we inject small amounts of botulinum toxin throughout the bladder using a needle and syringe. This takes about 10-15 minutes. You are checked to make sure that you are able to urinate before leaving for home.

What kind of results can I expect with Botox injections for overactive bladder?

Botox has been thoroughly researched for treating overactive bladder. Here are some numbers:

  • Botox injections resulted in an average of 3 less leakage episodes per day at week 12.
  • At week 12, Botox reduced daily leakage in a majority of patients by half, with many of these patients having episodes reduced by 75%, and about one quarter of these patients having their episodes completely stopped.

When can I expect to see results from Botox injections for overactive bladder?

After receiving your first Botox injections at UT Urology, most patients begin to notice results beginning in two weeks. Full results are seen by week 12. This is the time it takes the Botox to relax the overactive bladder muscle causing your problems.

How long will Botox injections provide relief from my overactive bladder?

Botox provides at least a 50 percent decrease in OAB symptoms for about 6 months. This timeframe can vary, and some patients may need re-treatment sooner.

Are there risks associated with botulinum toxin for overactive bladder?

The most common side effects seen with botulinum toxin treatment are urinary tract infections, pain with urination and difficulty emptying the bladder (called urinary retention).

Around 6-7% of patients who undergo botulinum toxin treatment will have difficulty emptying their bladders afterward. This may result in the need to empty your with a small catheter. This effect will wear off over time but may last several weeks to months.

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Should I be concerned about getting a urinary tract infection from Botox?

Woman suffering urinary incontinence and holding stomachUrinary tract infections are the most common side effect with Botox injections for overactive bladder, occurring in 18% of patients during clinical studies (versus 6% with placebo). To help prevent this, you will be given an antibiotic the day prior to your treatment, and you will have a prescription to use afterwards.

Do Botox bladder injections hurt?

Your bladder is first filled with a numbing agent. You are also offered a sedative, if you would like. The Botox injections are delivered through a small lighted tube called a cystoscope that is inserted into your bladder through your urethra. Due to the lidocaine (numbing agent), you don’t feel anything.

What is my next step?

At The OAB Clinic at Erlanger East, we have extensive experience with all available treatment options for OAB, including botulinum toxin injections. Our OAB Clinic is headed by the only urologist in the region with fellowship training that includes a focus on incontinence. Visit the OAB Clinic for a full evaluation and review your options for taking control of your bladder symptoms.

Schedule a Consultation

If you think a botulinum toxin injection is the solution for your overactive bladder, fill out our contact form to schedule a consultation. UT Urology serves Chattanooga, Cleveland, and East Ridge, TN.

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