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?
Botulina 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 Botulina 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 Botulina Work?
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 Botulina 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 Botulina?
- 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.