Procedures
Botulinum Toxin Injection
Why Choose the Botulinum Toxin Injection?
This treatment prevents involuntary urine leakage and urgent or too frequent needs to urinate.
The injection of this toxin is offered if the oral medicines taken to control bladder contractions are poorly performing or are insufficiently effective.
This intervention is increasingly used by patients with idiopathic and overactive bladder who are refractory to medical treatment, and by patients with secondary effects of incontinence due to a neurological problem.
Botox is an expensive drug. It is now covered by the RAMQ with an application for exemption by a doctor. Botox is also generally covered by private insurance companies.
How Does This Treatment Work?
The Botulium toxin is injected into the thickness of the bladder’s wall.
Botox reduces uncontrolled contractions of the bladder and diminishes the urgent needs by acting on the nerve endings contained within its walls. The urine leaks and the urgent desires are thus eliminated or significantly reduced.
The effect of the Botox begins from 2 to 10 days after the injection. It works temporarily during an average of 6 to 9 months. However, there can be variations in efficiency from a patient to another.
When the effect disappears, this toxin can be re-injected as many times as necessary with an interval of 3 months between each operation.
Botox reduces uncontrolled contractions of the bladder and diminishes the urgent needs by acting on the nerve endings contained within its walls. The urine leaks and the urgent desires are thus eliminated or significantly reduced.
The effect of the Botox begins from 2 to 10 days after the injection. It works temporarily during an average of 6 to 9 months. However, there can be variations in efficiency from a patient to another.
When the effect disappears, this toxin can be re-injected as many times as necessary with an interval of 3 months between each operation.
How Does An Intravesical Injection of Botox Work?
First, a catheter is inserted into the bladder. This gives a good anesthesia of the bladder wall after performing the intravesical instillation of Xylocaine in the bladder for a period of 30 minutes. The local anesthesia will soothe the sensation of pain, but you might perceive the sensation of touch of the needle, which can be unpleasant.
A flexible or a rigid cystoscope is inserted through the urinary channel. Your bladder is then inspected and pricked with a fine needle for 10 to 20 times in order to inject the total dose of the Botox in the thickness of the bladder’s wall. The procedure itself takes less than 5 minutes. You can follow the whole process through the monitor screen. The initial recommended dilution is of 100 units in 10 ml of a saline solution at 0.9 %.
A flexible or a rigid cystoscope is inserted through the urinary channel. Your bladder is then inspected and pricked with a fine needle for 10 to 20 times in order to inject the total dose of the Botox in the thickness of the bladder’s wall. The procedure itself takes less than 5 minutes. You can follow the whole process through the monitor screen. The initial recommended dilution is of 100 units in 10 ml of a saline solution at 0.9 %.
What Are the Risks and the Complications of Intravesical Injection of Botox?
Some rare complications are related to the cystoscopy and to the punctures made in the bladder wall:
No serious side effects related to the Botulinum toxin injections in the bladder have been reported in 7 years of study of this treatment.
- pain or discomfort during the insertion of the endoscope in the urethra or during the injections
- visible bladder bleeding for more than 12 hours
- urinary retention is the main side effect (decrease of the strength of the bladder that can sometimes result in a bladder blockage). However, this complication is temporarily and only lasts a few weeks to a few months. Self-catheterizations are then sometimes necessary
- moderate fever (<38.5 °C) of less than 48 hours
- urinal infection despite the use of antibiotic prophylaxis
No serious side effects related to the Botulinum toxin injections in the bladder have been reported in 7 years of study of this treatment.
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Cancellation policy
Dr. Marois is a urologist who is not a member of the Régie de l’Assurance Maladie du Québec (RAMQ). As such, if you require his professional services, you will have to pay directly the Cliniques Marois for the services rendered.
Cancellation Policy:
To ensure the smooth running of the clinics aa well as a minimum of courtesy towards other patients and staff members, we ask you to notify us 48 hours in advance for cancelling an appointment, 5 working days for cancelling a minor surgery in the office and 21 working days for major surgery at the CMC. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.
Change of appointment:
We understand that events occur and schedules change, so we ask patients to give us at least a 24-hour notice for any changes of appointment. We will be happy to reschedule another one for you. Failure to provide such notice within this timeframe will result in a $ 100 fee.
Thank you for your understanding.