Botulinum Toxin Bladder Injection

What is Botulinum Toxin Bladder Injection

Botulinum toxin bladder injection is a procedure to treat an overactive bladder. During the procedure, a drug called botulinum toxin is injected into the bladder through a long, thin needle. This drug relaxes the bladder muscles and reduces overactivity.

You may need this procedure if your medicines are not working or you cannot take them. The procedure may be repeated as needed.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Other medical conditions you have.
  • Any previous reactions to a botulinum toxin injection.
  • Any symptoms of urinary tract infection. These include chills, fever, a burning feeling when passing urine, and needing to pass urine often.

What are the risks?

Generally this is a safe procedure. However, problems may occur, including:

  • Not being able to pass urine. If this happens, you may need to have your bladder emptied with a thin tube (bladder catheter).
  • Bleeding.
  • Urinary tract infection.
  • Allergic reaction to the botulinum toxin.
  • Pain or burning when passing urine.
  • Damage to other structures or organs.

What happens before the procedure?

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • You may be given antibiotic medicine to help prevent infection.
  • Plan to have someone take you home after the procedure.

What happens during the procedure?

  • You will be asked to empty your bladder.
  • To reduce your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • An IV tube will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • A long, thin scope called a cystoscope will be passed into your bladder through the tube that carries urine from your bladder (urethra).
  • The cystoscope will be used to fill your bladder with water.
  • A long needle will be passed through the cystoscope and into the bladder.
  • The botulinum toxin will be injected into your bladder. It may be injected into multiple areas of your bladder.
  • Your bladder will be emptied, and the cystoscope will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • Do notdrive for 24 hours if you received a sedative.

Care After Botulinum Toxin Bladder Injection

These instructions give you information about caring for yourself after your procedure. Your doctor may also give you more specific instructions. Call your doctor if you have any problems or questions after your procedure.

Follow these instructions at home:

  • Do notlie down for 4 hours after treatment or as told by your doctor.
  • Do notrub the area where you got a shot. This can spread the toxin.
  • Depending on where the shot was:
    • Your doctor may ask you not to move your muscles in that area. Follow instructions from your doctor.
    • Your doctor may tell you to frown or squint regularly. You may need to do these exercises every 15 minutes for 1 hour after treatment, or as told by your doctor. Follow instructions from your doctor.
  • Do notdo any activities that take a lot of effort (are strenuous) for 2 hours after the procedure or for as long as told by your doctor. This includes:
    • Lifting heavy items.
    • Working out.
    • Doing activities that make your heart beat more quickly.
  • Do notget laser treatments, facials, or facial massages for 1–2 weeks after the procedure or for as long as told by your doctor.
  • If directed, apply ice to the area where you got a shot:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.
  • Take over-the-counter and prescription medicines only as told by your doctor.

Keep all follow-up visits with your doctor. This is important.

Contact a doctor if:

  • You have neck pain.
  • You have a headache that gets worse.
  • You feel sick to your stomach (nauseous) and it gets worse.
  • You feel unusually sleepy.
  • You have pain, tightness, weakness, or spasms in your face or neck.
  • Your mouth is dry.
  • You have trouble pooping (constipation).
  • You feel worried or nervous (anxious).

Get help right away if:

  • You have chest pain.
  • You faint.
  • You have a fever.
  • You have signs of an allergic reaction. These include:
    • An itchy rash or welts.
    • Wheezing or shortness of breath.
    • Dizziness.
  • You have double or blurred vision.
  • The black centers of your eyes (pupils) start to get bigger (dilate) and are sensitive to light.
  • Your eyelids start to get droopy or swollen.
  • You have trouble speaking.
  • You feel short of breath or have trouble breathing.
  • Your voice changes or starts to sound hoarse.
  • You start to have trouble swallowing.
  • You have muscle pain, weakness, or spasms in other parts of your body.
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