Botulinum toxin is used in patients with overactive bladder problems, who have failed to get satisfactory response from standard medical therapies (e.g. anticholinergic drugs). Prior to considering suitability for Botulinum Toxin injection therapy you will undergo urodynamic test first this is to ascertain the bladder condition and aid in counselling for the therapeurtic procedure.
How does it work?
Botulinum toxin works by inhibiting the release of special chemical from the nerve endings in the wall of the bladder, therefore allows the bladder muscle to relax, thus help reduce/control the symptom of urgency and improve continence control.
What is the success rate, how long does the effect last for?
From the current clinical evidence in the litrature, approximately over 80% of patients will have satisfactory response with better control and no incontinence episodes.
How is it administered?
The procedure is usually carried out under local anaesthetic. A local anaesthetic gel applied into the urethra (water passage) to allow passage of a flexible cystoscope (telescope) into the bladder and with a fine flexible needle the Botulinum toxin is injected throughout the bladder wall. Some discomfort is common and rarely painful. The procedure takes approximately 20 minutes.
What are the side effect and complications?
You might notice some blood when passing urine afterwards, this usually settles by drinking plenty of fluid. Approximately 5% of patients might respond “too well” resulting in the bladder being completely relaxed, thus having difficulty to void and empty the bladder satisfactorily; this often required a period of intermittent cathetrisation (this will be explained to you by your urologist and how to address it)
How long will the effect of Botulinum Toxin last?
Curent research evidence suggest a satisfactory response between 6 -9 months and re-injection is required by then.