Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
BOTOX® Injections for Urinary Incontinence
BOTOX® (onabotulinumtoxinA) injections are one of the treatment options I offer for patients with overactive bladder (OAB) and urge urinary incontinence.
How BOTOX® Works for Bladder Control
BOTOX® works by relaxing the overactive muscles in the bladder that cause urgency, frequency, and urge incontinence.
- The medication is injected directly into the bladder muscle during an in-office procedure.
- It reduces involuntary contractions of the bladder, giving you better control over urination.
- Effects typically last 6-9 months before retreatment is needed.
The BOTOX® Procedure
The procedure is relatively quick and can usually be performed in the office:
- Your bladder is numbed with a local anesthetic.
- A cystoscope (a small camera placed into the bladder) is inserted through the urethra into your bladder.
- Using the scope, I inject small amounts of BOTOX® into multiple areas of the bladder muscle.
- The entire procedure typically takes about 30 minutes.
Most patients can return to their normal activities the same day, although you may experience some discomfort or urinary symptoms for a few days after the procedure.
Benefits of BOTOX® for OAB
- Fewer daily incontinence episodes
- Less urgency and frequency
- Effects last several months, so you don’t need to take a daily pill
Potential Side Effects and Considerations
BOTOX® for OAB does come with some risks:
- Urinary tract infection
- Difficulty urinating or inability to empty the bladder completely
- Blood in the urine
- Fatigue
I discuss these risks with every patient beforehand so you know what to watch for.
Is BOTOX® a good choice for you?
BOTOX® may be worth considering if you:
- Have moderate to severe OAB symptoms
- Are looking for an alternative to daily medication
- Are comfortable with periodic injections (every 6-9 months)
- Don’t have certain neurological conditions or other contraindications
BOTOX® is one of several options for managing OAB, and it’s not the right fit for everyone. We’ll talk through your symptoms and goals to figure out what makes sense for you.
References
- Nitti VW, Dmochowski R, Herschorn S, et al. OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial. J Urol. 2013;189(6):2186-2193. doi:10.1016/j.juro.2012.12.022
- Chapple C, Sievert KD, MacDiarmid S, et al. OnabotulinumtoxinA 100 U significantly improves all idiopathic overactive bladder symptoms and quality of life in patients with overactive bladder and urinary incontinence: a randomised, double-blind, placebo-controlled trial. Eur Urol. 2013;64(2):249-256. doi:10.1016/j.eururo.2013.04.001
- Amundsen CL, Richter HE, Menefee SA, et al. OnabotulinumtoxinA vs sacral neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA. 2016;316(13):1366-1374. doi:10.1001/jama.2016.14617
- Cameron AP, Engel WJ, Engel A, et al. The AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder. J Urol. 2024;212(1):11-20. doi:10.1097/JU.0000000000003985