This is the injection of Botulinum Toxin (Botox) into the wall of the bladder to reduce urinary urgency, frequency and urinary incontinence. Other treatments include: bladder retraining, pelvic floor exercise and fluid and dietary advice and anticolinergic medication.

This treatment is offered if you suffer from an overactive bladder with symptoms of urinary urgency, frequency or where other treatments have failed, or if you are unable to tolerate unpleasant side effects of medication.

Before your procedure you will be referred to the urology/ urogynae nurse specialist to be taught Clean Intermittent Self Catheterisation. You must feel happy with this procedure to empty your bladder using a small tube, before your injections can be performed. Your urine will be tested to ensure that you are clear of urinary tract infection. You will be asked to take a sample of urine to your GP 10 days before your procedure to test for infection. Patients should not undergo injections if there is a suspicion of infection.

If you are pregnant or may become pregnant please discuss this with your doctor; Botox injections are NOT advised. If you are taking Aspirin, this should be stopped 7 days before the procedure to reduce the risk of bleeding.

You will be asked to provide a fresh sample of urine so that it may be tested for infection. If you are of childbearing age you will be asked to bring in an early morning sample of urine to test for pregnancy. You will then proceed to having the injections.

This procedure is carried out under local or general anaesthetic. An anaesthetic gel will be applied to the urethra and a flexible bladder telescope (cystoscope) is passed into the bladder. The bladder will then be injected with 10 units of Botox at 20 to 30 spots.

It is common for your urine to have a small amount of blood staining after this procedure. This normally settles within 48 hours. After one week use Clean Intermittent Self Catheter (CISC) after emptying your bladder normally. Measure the urine you have drawn off using the catheter (residual). If it is greater than 100mls commence regular CISC following the frequency guide you have been given. This will help to improve the drainage of the bladder and prevent urinary tract infection. If the residuals are less than 100mls repeat CISC weekly for the next two weeks. Measure and record all residuals. One week after the injections and again at three weeks after the injections you will receive a telephone call from the Nurse Specialist to monitor your progress.