Botulinum Toxin (BOTOX®) Injections for Overactive Bladder (Female)


This outpatient procedure is a series of long-lasting injections of botulinum toxin (commonly referred to by the brand name BOTOX®) administered into the muscle of the bladder wall to control the spasms that result in overactive bladder. The injections are performed through a cystoscope, a thin viewing telescope equipped with a light and camera that is inserted through the urethra. The procedure takes about 10-15 minutes to perform.

Inserting the Cystoscope

In preparation for the procedure, the patient is positioned, the urethral opening is swabbed with an antiseptic and anesthesia is administered. The physician carefully inserts the cystoscope into the urethra and advances it into the bladder. The physician irrigates the bladder through a channel in the cystoscope, filling the bladder with fluid to expand it and allow a clear view of the bladder’s wall.

The Injections

Once the cystoscope is properly positioned, the physician threads a thin needle down through the channel in the cystoscope and carefully advances it into the bladder lining. A small amount of Botox is injected into the tissue. The physician will administer 20-30 of these injections to treat a large area of the muscular bladder wall. The injections will disrupt the signals that cause the uncontrollable contractions of the bladder and the frequent, sudden urges to urinate.

End of Procedure

When the procedure is complete, the fluid is drained, the cystoscope is removed and the patient is allowed to resume normal activities. The injection can improve bladder function for a period of up to 10 months before its effect wears off and the injection needs to be repeated.