Bladder Injection with Botulinum Toxin A

Indication

  • Overactive bladder refractory to medication, or when medication is contraindicated.

Technique

Contraindications

  • Urinary retention.
  • Bladder malignancy.

Complications

  • Generalized muscle weakness (extremely rare).
  • Allergic reaction.
  • Bladder pain or discomfort.
  • Persisting hematuria.
  • Urinary tract infection.
  • Bladder emptying disorder from a mild increase in post-void residual volume up to urinary retention with need for intermittent self-catheterization.

Postoperative Management

  • Early discharge after proving normal urination.
  • Follow-up in 10 days (maximal effect).
  • The effect may last from 6 months to 1.5 years, the patient is encouraged to return when symptoms do.
  • Discontinue anticholinergic medication.

Bibliography

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