Intravesical Botulinum Toxin A Injections (Botox®)

Urology

What is Intravesical Botox®?

Intravesical Botox® (Botulinum Toxin A) is a minimally invasive procedure for the treatment of Overactive Bladder (OAB).

It involves the injection of Botulinum Toxin A into the bladder wall to relieve OAB symptoms.

Botulinum toxin acts on the bladder muscle, thereby preventing muscle contraction temporarily. As such, for sustained effect, more than one treatment session may be necessary.

Who is suitable for Intravesical Botox®?

Intravesical Botox® improves symptoms of frequency and urgency for those who have tried but have inadequate response to dietary and lifestyle modification, and/or are unable to tolerate oral medications.

How is the procedure performed?

This procedure is commonly performed under Anaesthesia as a day surgery or overnight stay procedure.

A camera (cystoscope) will be introduced into the bladder for direct visualisation of the bladder wall to allow injection of Botox® at multiple sites of the bladder wall.

Figure

Sites of Botox® injections into bladder wall

Source: Elsevier Inc. Urology

Are there any risks involved? Complications from Intravesical Botox® are rare, but the risks of the procedure include the following:

• Mild burning on passing urine after the procedure

• Blood in the urine (gross haematuria)

• Urinary tract infection

• Difficulty passing urine after the procedure

• Botulinum toxicity (rare)

1.

In the event of retention of urine after the procedure, you may need to empty your bladder via selfcatheterisation or require an indwelling urine catheter till the next clinic review.

What are the alternatives?

The alternative treatments for OAB include:

• Posterior Tibial Nerve Stimulation (PTNS)

– a clinic-based procedure over multiple sessions that involves electrical stimulation of the nerves to the bladder via the ankle

• Sacral Neuromodulation (SNM) – placement of a small pacemaker device in your back to modulate bladder control

• Augmentation Cystoplasty – a major surgery that uses part of your bowel to improve the bladder capacity

Post-procedure advice

• You will be able to travel home and continue your activities after the treatment

• Your response to treatment will be evaluated during the treatment courses and if successful, further sessions can be arranged

• You may experience some burning sensation during and after urination for up to 6 hours. Do drink lots of fluid to minimise this and to prevent urinary tract infection

• The effects of intravesical Botox® can last up to 12 months, after which, further treatment sessions may be required to maintain treatment effect

When should I seek medical attention after the surgery?

Please seek medical attention if you experience:

• Difficulty passing urine/unable to pass urine

• Fever, chills

• Worsening haematuria /blood clots in the urine

Contact Information

Please contact our Customer Contact Centre at 6555 8828 for an urgent appointment to return to the Urology Clinic during Office Hours.

For any emergency after office hours, please proceed to the KTPH Acute and Emergency Department (A&E).