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Botox has been used safely for the treatment of overactive muscles - Overactive Bladder (OAB) - which cause various forms of muscle spasm and spasticity. The bladder muscle can also become somewhat automatic in its behaviour, or overactive, contacting involuntarily. Botox can be used to decrease the activity. The result of injecting Botox into the bladder muscle is to suppress episodes of incontinence and increase the bladders capacity. Sometimes it is used to improve urethral function e.g. to make it easier to pass a catheter or urinate.
Preparation for the procedure
Antibiotics are used to prevent infections associated with procedures done when the bladder has this type of problem; an oral antibiotic will be given to you prior to the procedure and sometimes another to take home to have before you go to bed.
The Botox is injected into the appropriate sites in the bladder under cystoscopic guidance i.e. visual examination with a telescope in the bladder to ensure accurate placement of the drug. The procedure takes approximately 30 minutes.
What can I expect afterwards?
A slight amount of blood may be present in the urine, but this is expected to settle within 24 hours. Some discomfort may be experienced initially, but this usually settles in the same time frame.
The effect of Botox as a therapy usually takes 4-7 days to reach maximum effect. This may be associated with urinary retention or an inability to urinate. Professor O'Connell and the nurse will have discussed the risk of urinary retention with you prior to going ahead with the injection. Urinary retention is the inability to pass urine spontaneously. This is treated with the intermittent passage of a catheter – a process called intermittent self catheterisation (see note below). The risk of urinary retention depends on the dose of Botox used and your underlying condition. For example, if the basis for the bladder problem is Multiple Sclerosis, 300 units are required to stop the severe problem and retention is expected. A risk-benefit discussion is required to determine the best dose for you. Generally, lower doses are associated with shorter duration of effect, less pronounced effect AND lower risk of retention.
You will likely be asked to keep a record of your urine output and complete a follow up questionnaire at specific intervals to demonstrate the effect of the Botox.
How much does Botox cost?
The cost of the procedure (receiving the treatment) will be discussed at your appointment and will vary depending on how many treatments you require.
Note: The Botox medication is not included in this amount. These accounts are paid separately.
Please note: you will receive an invoice from Slade Pharmacy for up to $41.30 per vial of Botox, or $6.60 if you have a concession card. Please be sure to show the receptionist this card at your appointment or call the pharmacy when you receive your invoice.
The co-payment is the amount you pay towards the cost of your PBS medicine. Many PBS medicines cost a lot more than you actually pay as a co-payment. From 1 January 2018, you pay up to $41.30 for most PBS medicines or $6.60 if you have a concession card. The Australian Government pays the remaining cost.
Jul 12, 2018 www.pbs.gov.au/info/about-the-pbs