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
- bloody This should clear up in a few days
- retention of urine. This may require temporary self-catheterisation for up to 1 month
- no retention of urine (20% incidence)
- no UTI