{"id":4442,"date":"2026-06-28T21:49:08","date_gmt":"2026-06-28T19:49:08","guid":{"rendered":"https:\/\/www.haab-urologie.fr\/test\/botulinum-toxin-injections-botox-bladder"},"modified":"2026-10-14T22:44:37","modified_gmt":"2026-10-14T20:44:37","slug":"botulinum-toxin-injections-botox-bladder","status":"publish","type":"expertise","link":"https:\/\/www.haab-urologie.fr\/en\/urologue-expertise\/botulinum-toxin-injections-botox-bladder","title":{"rendered":"Botulinum toxin injections (Botox\u00ae bladder)"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"<p>Calming an overactive bladder without major surgery Discover botulinum toxin injections for treating overactive bladder. Professor Fran\u00e7ois Haab explains the indications, results, risks, and precautions. consultation appointment FAQ \u2013 Frequently\u2026<\/p>\n","protected":false},"featured_media":4507,"menu_order":0,"template":"","class_list":["post-4442","expertise","type-expertise","status-publish","has-post-thumbnail","hentry"],"acf":{"haab_subtitle":"Calming an overactive bladder without major surgery","haab_intro":"Discover botulinum toxin injections for treating overactive bladder. Professor Fran\u00e7ois Haab explains the indications, results, risks, and precautions.","haab_related_expertises":"","haab_related_besoins":"","haab_card_excerpt":"Discover botulinum toxin injections for treating overactive bladder. Professor Fran\u00e7ois Haab explains the indications, results, risks, and precautions.","haab_form_shortcode":"","haab_primary_label":"consultation appointment","haab_primary_url":"https:\/\/www.doctolib.fr\/chirurgien-urologue\/paris\/francois-haab\/booking\/telehealth-suggestion?specialityId=177&profile_skipped=true&bookingFunnelSource=external_referral","haab_secondary_label":"","haab_secondary_url":"","haab_card_image":4508,"haab_hero_image":4370,"haab_videos":[{"url":"https:\/\/www.youtube.com\/watch?v=6BBT_N5sJD0","title":"My review in video"}],"haab_video_eyebrow":"","haab_video_section_title":"","haab_video_section_text":"","haab_faq_title":"FAQ \u2013 Frequently Asked Questions","haab_faq_items":[{"question":"How does Botox affect the bladder?","answer":"Injected into the bladder muscle, Botox temporarily blocks the involuntary contractions responsible for urinary urgency and leakage. It is used to treat overactive bladder that is resistant to medication."},{"question":"How is the injection performed?","answer":"The injection is administered via the natural orifices, under endoscopic guidance, during a short outpatient procedure, under local or brief general anesthesia. The procedure lasts approximately ten minutes."},{"question":"How long is the treatment effective?","answer":"The effect appears within one to two weeks and lasts on average 6 to 9 months. The injections can then be repeated, with lasting effectiveness."},{"question":"What are the possible side effects?","answer":"The main risk is incomplete bladder emptying, which is temporary and may require temporary self-catheterization in a minority of patients. Urinary tract infections are also possible. These risks are systematically explained before treatment."}],"haab_sidebar_rdv_title":"","haab_doctor_band_title":"","haab_doctor_band_text":"","haab_doctor_band_points":null,"haab_doctor_band_image":"","haab_page_cta_title":"","haab_page_cta_text":"","haab_closing_highlights":null,"haab_blocks":[{"acf_fc_layout":"image_text_block","eyebrow":"","title":"What is this ?","content":"<strong>Intradetrusor injection of botulinum toxin (Botox\u00ae)<\/strong> is a minimally invasive urological treatment designed to reduce the symptoms of <strong>overactive bladder,<\/strong> such as urgency, frequency, and urge incontinence, when first-line treatments (medication, pelvic floor exercises) are not sufficiently effective. This treatment involves injecting small doses of toxin into the bladder wall (detrusor muscle) to modulate local nerve activity and reduce involuntary contractions.","image":4370},{"acf_fc_layout":"image_text_block","eyebrow":"","title":"In what cases?","content":"<h3><strong>Indications<\/strong><\/h3> Bladder botulinum toxin injection is considered in the following cases:<ul><li> Overactive bladder <strong>refractory<\/strong> to first-line treatments (anticholinergics, beta-3 agonists) or in case of intolerance to these treatments. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Presence of symptoms including at least: three episodes of urge urinary incontinence over 3 days <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u>a urinary frequency \u2265 8 urinations per day <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Patient acceptance of the risk of transient urinary retention and the possibility of <strong>self-catheterization<\/strong> if necessary. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Sterile urine at the time of injection (treated urinary tract infection or absence of infection). <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul>Note: In France, the marketing authorization for Botox mainly concerns idiopathic overactive bladder, and its use in this indication must comply with good practice recommendations.<u><\/u><hr \/><h3> <strong>surgical technique<\/strong><\/h3> Here is how a typical bladder botulinum toxin injection is performed: <strong>1. Preparation before the injection<\/strong><ul><li> Cytobacteriological control of urine to ensure the absence of infection. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Urodynamic assessment (in many cases) to confirm the diagnosis and guide the dose. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Information, obtaining consent, assessment of the ability to perform self-catheterization if needed. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Local anesthesia (urethral or bladder lidocaine instillation), sometimes sedation or anesthesia depending on the context. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><strong>2. Performing the injections<\/strong><ul><li> By endoscopic route (cystoscopy): a fine needle injects the toxin into the bladder muscle (detrusor) at 10 to 20 points distributed in the bladder wall, avoiding the ureteral meatuses. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Micro-volumes (0.5 to 1 mL per injection, containing several units of toxin) are used to achieve the intended dose. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Bladder filling is controlled to avoid excessive distension of the wall. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>It is not necessary to leave a bladder catheter except in cases of significant hematuria. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><strong>3. Duration and hospitalization<\/strong><ul><li> The procedure is relatively quick, often performed on an outpatient basis or with a short hospital stay. <u><a href=\"https:\/\/www.chuv.ch\/fr\/offre-en-soins\/portail-des-medecins-installes\/medchuv\/adresser-un-e-patient-e\/consultation\/medchuv_prest_511\/injection-intra-detrusorienne-de-toxine-botulique-botox-dysport\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>The patient is monitored until urination resumes. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul>","image":3183},{"acf_fc_layout":"image_text_block","eyebrow":"","title":"What you need to know","content":"<h3><strong>Expected results & duration of effect<\/strong><\/h3><ul><li> The clinical effect usually begins within <strong>2 to 10 days<\/strong> after injection. <u><a href=\"https:\/\/urologieparisouest.com\/pathologies-urologie\/femme\/hyperactivite-vessie\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>On average, the effect lasts <strong>6 to 9 months<\/strong> , depending on the patient and the dose. <u><a href=\"https:\/\/urologieparisouest.com\/pathologies-urologie\/femme\/hyperactivite-vessie\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>If symptoms return, a new injection may be considered provided that a <strong>minimum interval of 3 months<\/strong> is respected between two injections. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Studies have shown that the use of Botox improves episodes of urinary incontinence and quality of life, even in patients requiring self-catheterization. <u><a href=\"https:\/\/www.urofrance.org\/fichebasecongres\/le-traitement-par-onabotulinumtoxin-a-botox-ameliore-lincontinence-urinaire-et-la-qualite-de-vie-des-patients-porteurs-dhyperactivite-vesicale-idiopathique-independamment-des-infections-urin\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><hr \/><h3><\/h3><h3><strong>Risks & complications<\/strong><\/h3> Like any medical procedure, injecting botulinum toxin into the bladder carries some risks:<ul><li> <strong>Transient acute urinary retention<\/strong> , requiring catheterization or self-catheterization. The retention rate varies depending on the dose, typically 5 to 10% in the months following injection. <u><a href=\"https:\/\/francais.medscape.com\/voirarticle\/3606629\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Potential <strong>urinary tract infection<\/strong> , hence the importance of monitoring urine. <u><a href=\"https:\/\/www.urofrance.org\/recommandation\/recommandations-pour-lutilisation-de-la-toxine-botulinique-de-type-a-botox-dans-lhyperactivite-vesicale-refractaire-idiopathique\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li><strong>Hematuria<\/strong> or temporary local bleeding<\/li><li> Mild to moderate bladder pain or discomfort<\/li><li> Partial failure or recurrence of symptoms<\/li><li> Long-term effects still need to be monitored (long-term safety profile poorly documented according to the HAS) <u><a href=\"https:\/\/www.has-sante.fr\/jcms\/c_1782527\/fr\/botox-toxine-botulinique-a-myorelaxant\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><div><\/div><div><\/div><hr \/><h3><\/h3><h3><strong>Contraindications & precautions<\/strong><\/h3><ul><li> Untreated urinary tract infection<\/li><li> Hypersensitivity to botulinum toxin<\/li><li> Neuromuscular disorders (e.g., myasthenia gravis)<\/li><li> Anticoagulation not suitable for an endoscopic procedure<\/li><li> Inability to self-catheterize (in case of retention)<\/li><li> Pregnancy, breastfeeding (according to medical advice)<\/li><li> Precautions in case of increased existing post-void residual<\/li><\/ul>","image":3189},{"acf_fc_layout":"list_block","eyebrow":"","title":"Specialist in botulinum toxin injections","text":"","items":[{"item":"He performs botulinum toxin injections in accordance with recommendations, with dose selection and individualized protocol."},{"item":"It provides rigorous support to the patient (information, risk assessment, post-operative follow-up)."},{"item":"In case of reinjection or partial failure, he may suggest complementary alternatives (neuromodulation, drug treatments, etc.)."}]},{"acf_fc_layout":"text_block","eyebrow":"","title":"My journey in video","content":"I made this video to introduce myself and describe my background and expertise."}]},"_links":{"self":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise\/4442","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise"}],"about":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/types\/expertise"}],"version-history":[{"count":1,"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise\/4442\/revisions"}],"predecessor-version":[{"id":4463,"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise\/4442\/revisions\/4463"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/media\/4507"}],"wp:attachment":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/media?parent=4442"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}