Treating an overactive bladder with intravesical Botox

Written by: Miss Nadia Rahman
Published: | Updated: 13/04/2023
Edited by: Robert Smith

There are a range of methods that can be used to treat an overactive bladder, including both medical therapy and lifestyle changes that can be implemented.

woman-after-intravesical botox


We recently spoke with Miss Nadia Rahman, a renowned consultant gynaecologist, to discuss overactive bladder and how Botox is often effective for treating this condition. Find out how you can tell if you have an overactive bladder and when Botox via an intravesical injection could be helpful.


How common is an overactive bladder?

Typically, overactive bladder symptoms are quite common in post-menopausal women; approximately 1 in 4-5 women experience this. Having said that, it is not uncommon in the under 55yrs age group. Infrequently some young women under 25yrs may experience these symptoms too.

How can you tell when you have an overactive bladder?

A woman may have an accident as she is attempting to get to the toilet, when walking, making any small movement or listening to/seeing running water taps.

How should an overactive bladder be treated?

The first steps to manage an overactive bladder is bladder retraining where the bladder is essentially taught to 'stretch' itself. Altering fluid intake and cutting down on bladder irritants compliments the above. Next step is a trial of medications. If these fail, transurethral Botox injections is the next step.

Botox acts by temporarily paralyzing the bladder muscle hence calming down a very irritable bladder and improving urgency. The success rate is about 60 to 70%.

What are the side effects of Botox injections in the bladder?

The downside is the risk of self-catheterization (up to 10%). If Botox calms down the muscles too much you may find it difficult to pass urine and would then have to use a catheter whilst your bladder recovers over time. This is something that you can be easily taught. Other minor risks are infection and bleeding.

When might intravesical Botox be needed?

If you continue to be troubled by severe urgency, urinary leaks without warning, on movement despite first-line measures / oral treatment and bladder muscle overactivity is proven on a urodynamics test, Botox may be a suitable option for you.

How long does it take for Botox injections in the bladder to work?

It can take about a week. A follow up would be arranged 2 weeks after the injection.

How often do injections need to be done?

Repeat Botox is often required as effects last for 8 months - 18 months on average.

During the pandemic, I am happy to see patients face-to-face.

Details about Botox treatment are available on the British Society of Urogynaecology website. For leaflets, information, or to have any questions answered, please feel free to contact my secretary.

If you will need treatment for an overactive bladder of if you are interested in intravesical Botox, we recommend getting in touch with Miss Nadia Rahman , a highly experienced urogynaecologist. Click here to visit her Top Doctors profile today.

By Miss Nadia Rahman
Obstetrics & gynaecology

Miss Nadia Rahman is a renowned Consultant Urogynaecologist who offers private care to patients at the Spire Cambridge Lea Hospital.

Miss Nadia Rahman's main areas of expertise include the management of female pelvic floor dysfunction that manifests as vaginal prolapse, genuine stress incontinence, mixed urinary incontinence, recurrent urinary tract infections and painful bladder syndrome

Miss Rahman's surgical expertise involves non-mesh procedures only: anterior vaginal wall repair, posterior vaginal wall repair, perineorrhaphy, vaginal hysterectomy, sacrospinous hysteropexy and sacrospinous fixation of the vault in women post-hysterectomy.

She specialises in bladder investigations such as Urodynamics test, cystoscopy and procedures such as intravesical Botox injections and urethral bulkamid injections. She also specializes in general gynaecology procedures such as Bartholin's cysts, vaginal cysts, scarring of vaginal introitus post childbirth, endometrial polyps, and contraception such as Mirena coil insertion and laparoscopic sterilization. 

Miss Rahman is committed to providing holistic and sensitive care to patients with vaginal prolapse, recurrent urinary tract infections, female urinary incontinence and other gynaecological concerns. She fully understands that these issues are often strongly associated with anxiety, embarrassment and can be difficult topics of discussion. She aims to educate as well as improve the quality of life of patients by applying sound clinical skills with a positive demeanour to aid in treatment and management of physical symptoms.

As an expert in her field, she manages expectations of treatment though educating, counselling, focusing on conservative measures and where appropriate, discusses the relevance of surgery.

In her 12 years service in the NHS, she has performed over 180 pelvic floor repairs (anterior +/- posterior colporrhaphy), 70 intravesical Botox/ urethral bulkamid procedures, over 80 vaginal hysterectomies / sacrospinous hysteropexy / sacrospinous fixation and over 100 diagnostic cystoscopy procedures. She is a trained urodynamicist and conducts and analyses tests regularly.

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