Botox and Incontinence

If you have urinary incontinence due to overactive bladder resulting from a neurologic condition, special tests performed in your urologist’s office are often used to diagnose and better understand the underlying problem, such as bladder muscle overactivity.1,2 These tests are called urodynamics.

Before recommending BOTOX® (onabotulinumtoxinA), your urologist may use these tests to measure1,2:

• Whether your bladder muscle contracts involuntarily when it is filling with fluid
• How much urine is left in your bladder after you are finished urinating
• How much pressure is inside your bladder during filling and emptying
• How much your bladder can hold (bladder capacity)

If you are living with a neurologic condition, it’s important to get regular assessments from your urologist. The special tests described above can help provide insight into the appropriate treatment for you and help your urologist understand how well your treatment is working.

BOTOX® is a prescription medicine that is injected into the bladder muscle. BOTOX® is usually administered by a urologist or urogynecologist. First your doctor will numb your bladder and then administer BOTOX®. Your urologist or urogynecologist can do this either in the office or as an outpatient service in the hospital.

Here is what you should know and do in the days leading up to your BOTOX® treatment, what you can expect on your treatment day, and what you should do after your BOTOX® treatment

Before Treatment With BOTOX®, Your Urologist Will:

• Explain how BOTOX® treatment is done and the results you may expect
• Instruct you to temporarily stop taking antiplatelets (aspirin-like products) at least 3 days before treatment
• Give you antibiotics one to 3 days before your treatment to help prevent urinary tract infection (UTI)
• Make sure you know that some people may need to begin using a catheter (clean intermittent catheterization) after treatment
• Provide education on how to use a catheter in case it becomes necessary to use one to drain your bladder completely

On Treatment Day With BOTOX®, Your Urologist Will:

• Test to make sure that you do not have a urinary tract infection (UTI)1
• Give you antibiotics to prevent UTI1
• Explain that you have options for anesthesia—either no anesthesia, local, regional, or general
• Administer BOTOX®
• After using anesthesia to numb your bladder, your urologist will make small injections in the bladder wall, where the bladder muscle is located
• Your urologist can do this either in the hospital or in his or her office
• The entire process can take less than an hour

After Treatment With BOTOX®, Your Urologist Will:

• Ask you to stay in the office for about 30 minutes1 to check your blood pressure and pulse rate and make sure that you have emptied your bladder2
• Give you antibiotics one to 3 days after your treatment1
• -Within 2 weeks after treatment and, as your doctor considers medically appropriate, up to 12 weeks
• Be sure to follow your urologist’s advice after your BOTOX® treatment. Your urologist will let you know when you need to come back for an appointment to measure your progress.