Botox Injections for Overactive Bladder (OAB) | Advanced Urology

How Botox Works for OAB

Overactive bladder symptoms are often driven by involuntary contractions of the detrusor muscle. OnabotulinumtoxinA (Botox) partially relaxes the detrusor to decrease these contractions. Most patients notice fewer urgent trips to the bathroom, fewer leakage episodes, and better sleep.

Who Is a Good Candidate?

Often Good Candidates

  • OAB with urgency, frequency, nocturia, or urgency incontinence
  • Inadequate relief or intolerance to medications (anticholinergics or beta-3 agonists)
  • Preference for procedural therapy versus long-term daily medications

May Not Be Suitable

  • Untreated urinary tract infection
  • Significant urinary retention or high post-void residual
  • History of severe reactions to botulinum toxin products

What to Expect: Our Process

1) Evaluation

We review your history, prior treatments, and bladder diaries, and check for infection. We discuss Botox, sacral neuromodulation, and other options to choose the best fit.

2) Procedure with Minimal Sedation

In our surgery center, we use minimal anesthesia/sedation for comfort. A cystoscope is used to inject Botox in small aliquots across the bladder wall. The procedure is brief, and you go home the same day.

3) Recovery & Follow-up

Expect transient burning with urination for a day. We monitor symptom response and bladder emptying. Effects develop over 1–2 weeks and typically last several months.

Benefits, Durability, and Side Effects

Benefits

  • Reduces urgency/frequency and incontinence episodes
  • Outpatient, quick recovery, minimal sedation
  • Useful when medications aren’t tolerated or effective

Durability & Repeat Treatments

Botox is temporary. Many patients need repeat injections to maintain benefit, typically every few months depending on response.

Risks & Side Effects

  • UTI risk: urinary tract infection can occur; we screen and treat promptly.
  • Temporary urinary retention: rarely, bladder emptying may be reduced; short-term catheterization can be required.
  • Minor bleeding/irritation after cystoscopy injections.

Botox vs. Sacral Neuromodulation (InterStim/Rechargeable Systems)

Botox

  • Renewable, injection-based therapy
  • Good for medication-refractory OAB
  • Requires repeat procedures for durability

Sacral Neuromodulation

  • Implanted device that modulates nerves controlling the bladder
  • We often use this for long-term control and durability
  • Two-stage trial then implant if effective

We offer both options and tailor recommendations to your goals, medical history, and response to prior treatments.

Next Steps