Urinary leakage is a common problem experienced by many women, but just because its common doesn’t mean it’s normal. When urinary leakage happens during activities like coughing, sneezing and laughing it is called stress incontinence, but when it happens with a strong feeling of urgency it is called urgency incontinence. Over the past two decades we have made significant strides in our ability to effectively treat problems like urinary leakage using therapies like bladder Botox.
So how exactly does bladder Botox work? First recall that urinary leakage problems can be treated in different ways using strategies like behavioral changes, pelvic floor physical therapy, medications, surgery and nerve stimulation. Botox works by relaxing the bladder muscle enabling the bladder to hold urine better so you can make to the bathroom in time. This property of Botox makes it very useful to treat urgency incontinence which happens when the bladder muscle contracts frequently leading to spontaneous loss of bladder control.
What exactly is bladder Botox?
Botox is made by extracting a useful protein from a bacterium called botulinum. It is then made into a drug that is administered through an injection by your physician. Most people are familiar with its use for the cosmetic treatment of wrinkles, but Botox has many other uses besides this. It has been shown to effectively treat symptoms of urgency urinary incontinence in about 60-90% of women. Botox in the bladder is done during a procedure called a cystoscopy. A cystoscopy is performed by placing a small camera in the bladder as its being filled with water. A small needle is then introduced though the camera and Botox is injected into the bladder muscle.
Is bladder Botox for urinary leakage safe?
Bladder Botox can be safely performed in an office setting using small amounts of local anesthesia. Most people tolerate the injections very well with minimal discomfort. It is a safe medication, but there are potential side effects most of which are temporary. Some women may complain of burning during urination, notice small amounts of blood in their urine or develop a bladder infection after Botox. At times Botox may work too well and you may not be able to empty your bladder. The good news is that most adverse effects from Botox are not permanent and resolve over time. Severe allergic reactions to Botox can occur but are typically rare.
What should I expect after bladder Botox?
Botox does not work immediately and may take up to two weeks before you notice improvement in your urinary leakage. The effect of botox typically lasts around 6-9 months, so this therapy needs to be repeated. Remember, Botox does not treat all types of incontinence so if you leak urine when you cough, sneeze, laugh or exercise then Botox will not be the right option for you.
Overall, Botox is a safe and effective treatment for urinary leakage problems associated with urgency. Talk with your doctor regarding this therapy to determine if this is the best choice for treatment of your bladder leakage issues.

I am board certified in Obsetrics and Gynecology (OBGYN) and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). I currently serve as the Medical Director of Female Pelvic Medicine for the Crozer Health Medical Group in the greater Philadelphia area. I obtained my residency training in OBGYN at the Los Angeles County+ University of Southern California Medical Center and fellowship training in FPMRS at Johns Hopkins. I am passionate about the field of Women’s Health and the treatment of pelvic floor disorders like urinary incontinence and pelvic organ prolapse.