Bladder Injections

Urge incontinence from overactive bladder

Muscle paralysing agent can be injected into the bladder to treat refractory cases of overactive bladder or urge incontinence that do not respond to medication. A total of 100U to 200U of Botulinum toxin A is injected into the wall of the bladder to paralyze the bladder muscle. The effect is seen as early as 2 weeks after injection. Success rates are around 70 to 80% but the effect lasts only up to 9 months. Repeat injections are then needed.

How it is done

The procedure is done under general anesthesia as a day case and takes about 15 minutes. A cystoscope is inserted and Botulinum A is diluted and via a long needle, injected under the bladder mucosa. The injection is distributed over 20 to 30 sites and a catheter is inserted at the end.

Diluted botulinium is injected under the mucosa via a cystoscope

Complications include:

  • bloody This should clear up in a few days
  • retention of urine. This may require temporary self-catheterisation for up to 1 month

Desired outcomes:

  • no retention of urine (20% incidence)
  • no UTI