One recent and popular way of treating this problem is by the injection of botox in various points into the musculature of the over active bladder, to weaken the muscles so the sudden involuntary contraction of the bladder muscles is much lessened.  Following is a video view through a cystoscope showing how botox treatment of over active bladder is done.

A cystoscope is inserted under anesthesia through the urethra or urinary passage into the bladder with the bladder fully distended with water. Close to about 100 units of botox are injected into 20 to 30 points in the muscular wall of the bladder. Effect comes on about 4 days after the botox injection. The desired effect is a massive reduction in the uncontrollable urge to pass urine and the ability to control the urine till a convenient time.

The exact cause of this overactive bladder problem is not known, but it is seen that some medications that block the effect of acetylcholine on the bladder wall muscles, thus reducing the abnormal bladder contractions that characterise an over active bladder. The unfortunate problem is that most of the medications that can work to reduce the overactivity of the bladder also have side effects such as mouth dryness, constipation, blurry vision, urinary retention and heartburn.

The botox procedure is relatively simple. A scope is inserted into the urethra with the patient under sedation so that the inside of the bladder wall can be seen. Small injections of botox are made into the bladder’s muscle wall.  Usually a total of 20 to 30 injections are given, with a total dose of about 100 units of botox. The whole procedure takes about 30 minutes to complete.

The beneficial effect comes on about 2 to 7 days after the injections. Most patients notice a more controllable and calmer bladder with obviously less urgency. Effects last anywhere between 6 to 9 months, after which the patient can have repeat injections for his over active bladder.

The above illustrates one of the medical uses of botox injection.  For non-medical uses or cosmetic uses of botox injection, please click on the link.

Bladder Cystoscopy