Intravesical Botox

Why is it done?

• To alter the neurotransmission from the nerve to muscle receptor.
• Refractory overactive bladders with urge incontinence.
• Chronic pelvic pain?
• Causative factors:
  • Undetermined
  • Neurogenic causes such as Multiple Sclerosis.
  • Non-neurogenic.
• NOT INDICATED FOR A PATIENT WITH A HIGH POST VOID RESDUAL URINE VOLUME

How is BOTOX administered

• A sedation/local anesthetic is administered.
• You will be placed supine with legs in comfortable frog position
• A flexible cystoscopy procedure is done.
• 20 sites of 1 ml blebs are created in a grid fashion with sub-mucosal injections of BOTOX.

• Usually, 100-200 IU with non-neurogenic bladders and 300 IU with neurogenic causes.
• Dose may be individualized with subsequent treatments.
• WARNING: You may not be able to pass urine for up to 2 weeks on your own and may require intermittent self-catheterization. Therefore, if you are not willing to self-catheterize, this is not for you

After the procedure?

• You will be assessed to see whether you empty your bladder completely.
• ISC may be instituted if you cannot void or residuals are more than 300cc.

What to expect after the procedure

• Some local discomfort may be experienced.
• Your voiding nature will change within the next week to 10 days with a slow stream which may require ISC in < 2% of patients.
• Systemic effects of BOTOX would cause muscle weakness with higher doses.
• If you require ISC, this may be required for 2-4 weeks, it will improve thereafter.
• Neurogenic bladder patients will still continue with ISC as before.
• NB! Each person is unique and for this reason symptoms may vary!

What next?

• A date will be set for a review by myself on regular intervals.
• Please don’t hesitate to direct all further queries to Dr Schoeman’s rooms.

Download Information Sheet

Wes Intravesical BOTOX