Principles of the Procedure
This procedure is performed in patients with proven bladder overactivity and urge incontinence or in patients with a neurological injury affecting bladder function. A cystoscopy is initially performed to assess the inside of the bladder. A series of small injections of Botox® is then injected into the bladder wall. The Botox® injections have the effect of partially ‘paralysing’ the bladder, reducing the urgency and urge incontinence.
Pre-Operative Preparation
This procedure may be done under general or local anaesthesia. Usually a recent urine sample will be obtained prior to the procedure to exclude any infection. If the procedure is performed in hospital (general anaesthesia), you will be admitted on the day and will need to be fasted 6 hours prior. If the procedure is performed in the rooms (local anaesthesia), you do not need to be fasted. A local anaesthetic solution will be instilled into your bladder for 20 minutes to numb the feeling of the injections. For both instances, you should continue to take all of your usual medications. Your urologist will inform you if you need to adjust any anticoagulant (blood thinning) medications prior to the cystoscopy.
Expected Post-Operative Recovery
You will be able to go home on the same day as the procedure, even being able to drive yourself home when the procedure in performed under local anaesthetic. Some blood staining of the urine and stinging when voiding can occur temporarily, though this almost always settles by keeping your oral intake of fluids up. The Botox® takes about 2 weeks to come in effect. You will be usually assessed at that time to review your symptoms and ensure that your bladder is emptying appropriately.
Risks - as per your discussion with your Urologist
Bleeding
Infection
Urinary retention or incomplete bladder emptying - needing catheterisation
Lack of desired effect
Bladder or urethral injury
Anaesthetic risks