Bladder Injections with Botulinum Toxin in the OR

Botulinum Toxin Type A (also known as Botox®) is a medicine that can be used to help muscles relax. It is injected into the bladder wall while your child is asleep in the operating room. During the procedure, the surgeon inserts a special tube with a camera (called a cystoscope) into the urethra to inject the medication into the muscle of the bladder. 

Botox® can be used to treat overactive bladders. Many patients with neurogenic bladder have an overactive bladder muscle. This can cause increased bladder pressure, a small bladder and increased urinary leaking. The injected medicine blocks electrical impulses from the brain, helping the bladder muscle relax and hold more urine. 

A scheduler will be contacting you with specific instructions on how to prepare for your injection procedure, including the need for a pre-operative evaluation and urinalysis with your primary care provider. Please follow the instructions exactly about when your child should stop eating and drinking.  

If you have any questions about your upcoming procedure, please call the urology team. 

Bladder injection with botulinum toxin in the OR typically lasts around 30 minutes. After surgery, your child will go to our recovery area for monitoring. This procedure is considered “minimally invasive” and is typically done on an outpatient basis. This means you and your child can likely return home the day of the procedure.  

After the Injection Procedure

The bladder may be irritated after surgery. This may cause pink-tinged urine or increased bladder spasms. This should subside in 24 hours. 

Please encourage your child to drink plenty of fluids after surgery. Your child can return to normal activities the next day. 

Please resume your typical bladder care regimen after surgery, unless instructed differently by your surgeon. 

It will take up to 2 weeks after surgery to see the effects of the injection. Effects include an increase in bladder volumes when catheterizing, decreased bladder spasms and decreased leaking between catheterizations.  

Your urology provider may instruct you to make changes to your bladder medications after surgery. Please follow these instructions. 

The botulinum toxin type A medication will wear off over time, typically around six months. As the medication wears off, your child may experience smaller bladder volumes when catheterizing, increased bladder spasms, and increased leaking between catheterizations.