Botox for overactive bladder in Salt Lake City
Botox for overactive bladder can reduce urgency and urge leaking when medication has not helped enough or is not tolerated. Elisabeth Ferlic, MD, is a board-certified urologist in the Salt Lake Valley with fellowship training in voiding dysfunction and female pelvic medicine. Her practice evaluates bladder symptoms in women and men, including those related to neurologic conditions.
Ask about bladder Botox or call 435-344-4760 to discuss an evaluation and treatment availability.
Elisabeth Ferlic, MD
Board-certified urologist · Fellowship-trained in voiding dysfunction and female pelvic medicine
In this guide
- Who bladder Botox is for
- What bladder Botox is and how it works
- Why see Dr. Ferlic for bladder Botox
- What are my options?
- Alternatives to bladder Botox
- How to prepare
- What happens during the procedure
- Recovery and results
- Risks and side effects
- What happens at the first visit?
- Frequently asked questions about bladder Botox
Who bladder Botox is for
Conservative options are described on the overactive bladder page. A clinician considers Botox for overactive bladder when medication has not helped enough or is not tolerated. The evaluation also considers these factors:
Who it may help
- Bladder retraining, pelvic floor therapy, and medication have not controlled your symptoms, or medication side effects were not worth the benefit
- You urinate eight or more times a day, wake two or more times a night, or leak with sudden urges
- Your bladder symptoms come from a neurologic condition such as multiple sclerosis, Parkinson's disease, or a spinal cord injury (see neurogenic bladder)
Who needs a different plan
- Who it is not for
- Anyone with an active urinary tract infection. The infection is treated first.
- People whose leaks come from coughing, sneezing, or exercise. That's stress incontinence. A spasming bladder doesn't cause it, so Botox does not help. The urinary incontinence page covers the treatments that do.
- People with emptying problems who are not using a catheter. Botox can make retention worse. Emptying problems, including those related to an enlarged prostate, need assessment before treatment. Some patients with neurologic conditions already use a catheter and need a different discussion.
Women and men are both candidates.
What bladder Botox is and how it works
Botox (onabotulinumtoxinA) is the same medicine used to soften facial wrinkles. It works in the bladder for the same reason: it relaxes muscle.
An overactive bladder contracts without warning, often before it's full. You feel a sudden urge that is hard to put off. Sometimes urine leaks before you reach the bathroom. That leak is called urge incontinence.
Botox blocks the nerve signals that tell the bladder muscle to tighten. Small amounts are injected directly into the bladder wall. The muscle relaxes and the bladder holds more. Urges come less often, and with more warning.
The FDA approved Botox for overactive bladder in 2013. It is also approved for adults whose leakage comes from a neurologic condition such as multiple sclerosis or a spinal cord injury. The effect wears off over several months, and the treatment can be repeated.
Why see Dr. Ferlic for bladder Botox
Dr. Ferlic is a urologist with fellowship training in voiding dysfunction and female pelvic medicine. That fellowship included neuro-urology, so she treats the nerve-related bladder conditions that need an assessment of bladder function and neurologic history. Botox is one of the main treatments for them.
Her visits aren't rushed. You hear every option, including the ones that don't involve a procedure, and her evaluation considers your symptoms, history, and treatment goals. Read more about Dr. Ferlic, or see the full scope of care on the women's pelvic health and men's urology pages.
What are my options?
A starting point for the conversation, not a prescription. Your evaluation decides what fits.
Urgency that medication hasn't controlled
Or medication side effects weren't worth the benefit
Bladder Botox
Injections into the bladder wall relax the muscle so it holds more
Leaking from a neurologic condition
Such as multiple sclerosis or a spinal cord injury
Botox for neurologic bladder leakage
Also approved for adults whose leakage comes from a neurologic condition
Leaking with coughs, sneezes, or exercise
That's stress incontinence, which Botox does not help
Stress incontinence treatments
The urinary incontinence page covers the treatments that do help
Trouble emptying your bladder
Botox can make retention worse if you don't use a catheter
Assessment before treatment
Emptying problems, including an enlarged prostate, are checked first
Alternatives to bladder Botox
Other procedural options for overactive bladder include nerve stimulation.
Sacral nerve stimulation (Axonics or InterStim). A small implanted device steadies the nerve signals between the brain and the bladder. Suitability for a neurologic bladder condition needs a separate assessment.
Tibial nerve stimulation (PTNS). A series of office sessions stimulates a nerve near the ankle to calm urgency.
Each option has tradeoffs: how often you come in, whether a device is implanted, and which side effects you accept. Botox means a short treatment every several months with no implant, and it carries the catheter risk described above. The choice depends on your bladder findings, preferences, medical history, and the treatment available.
The conservative options stay open too. The overactive bladder page lays out every step in order.
| Bladder Botox | Sacral nerve stimulation | Tibial nerve stimulation (PTNS) | |
|---|---|---|---|
| How it works | Relaxes the bladder muscle so the bladder holds more | Steadies the nerve signals between the brain and the bladder | Stimulates a nerve near the ankle to calm urgency |
| How it's given | Small injections into the bladder wall through a cystoscope | A small implanted device | A series of office sessions |
| What to weigh | A short treatment every several months with no implant, and a catheter risk | An implant; suitability for a neurologic bladder condition needs a separate assessment | How often you come in for sessions |
Bladder Botox
- How it works
- Relaxes the bladder muscle so the bladder holds more
- How it's given
- Small injections into the bladder wall through a cystoscope
- What to weigh
- A short treatment every several months with no implant, and a catheter risk
Sacral nerve stimulation
- How it works
- Steadies the nerve signals between the brain and the bladder
- How it's given
- A small implanted device
- What to weigh
- An implant; suitability for a neurologic bladder condition needs a separate assessment
Tibial nerve stimulation (PTNS)
- How it works
- Stimulates a nerve near the ankle to calm urgency
- How it's given
- A series of office sessions
- What to weigh
- How often you come in for sessions
How to prepare
Before bladder Botox, your clinician checks for a urinary tract infection and reviews whether your bladder empties well. Tell the treating team about all medicines and supplements, previous Botox treatments, allergies, and any muscle, nerve, swallowing, or breathing problem.
Ask for instructions about antibiotics, eating, driving, and blood thinners. Don't stop a prescribed medicine without instructions from the clinician responsible for it. Preparation depends on the setting and anesthesia.
What happens during the procedure
Bladder Botox is injected into the bladder muscle through a cystoscope, a thin instrument passed through the urethra. No skin incision is needed.
Numbing medicine, sedation, and the treatment setting depend on the plan. The clinician places small injections at several sites in the bladder wall. Ask what sensations to expect and how discomfort is managed.
Before leaving, confirm the instructions for bladder emptying, follow-up, and symptoms that need urgent care.
Recovery and results
Improvement develops over days rather than immediately. Results often last several months, and some patients have repeat treatment when symptoms return. Response and duration vary, so a repeat procedure depends on your symptoms, the recommended interval, and the safety review.
Mild burning or a small amount of blood in the urine can occur after treatment. Follow the treating clinician's instructions about activity, medicines, driving, and when to seek help.
Follow-up includes checking symptoms and bladder emptying. Confirm the timing before treatment, especially if you do not already use a catheter.
Risks and side effects
Bladder Botox has risks that need discussion before treatment:
What treatment can address
- Fewer sudden urges, with more warning
- Less leaking with sudden urges
- Leakage from a neurologic condition such as multiple sclerosis
- Repeat treatment when symptoms return
What to weigh first
- Some patients need a catheter, sometimes for weeks or months
- Improvement develops over days, and the effect wears off over several months
- Infection, burning, or blood in the urine can follow treatment
- An active urinary tract infection must be treated first
- Rare effects beyond the bladder need emergency care
- Urinary tract infection. Tell the treating team about burning, fever, worsening urgency, or other infection symptoms.
- Difficulty emptying the bladder. Some patients need catheterization after treatment, sometimes for weeks or months. The risk differs between overactive bladder and neurologic bladder conditions. Discuss whether you can use a catheter if needed and how emptying will be monitored.
- Bleeding or discomfort. Burning and blood in the urine can follow the injections. Worsening or persistent symptoms need assessment.
- Effects beyond the bladder. Botox carries a warning about spread of its effects. Trouble breathing, swallowing, or speaking, or significant muscle weakness after treatment needs emergency care. Call 911 for breathing or swallowing difficulty.
If you cannot urinate, seek emergency care. Don't wait for a routine follow-up.
What happens at the first visit?
The visit starts with what has changed and what you want help with. Any treatment and follow-up plan is specific to you.
Talk through your symptoms
Bring your concerns, medication list, and relevant medical history.
Decide what needs checking
Testing depends on your symptoms and history, and some concerns need a separate workup.
Discuss a plan and follow-up
Review benefits, risks, alternatives, and what to watch for.
Before you schedule
Ask which appointments are available and whether your concern suits a video visit or needs an in-person evaluation.
Here’s what our great patients say
How long does Botox for overactive bladder last?
The effect often lasts several months, but response and duration vary. Improvement develops over days. Repeat treatment depends on symptoms, the recommended interval, and a safety review.
Will I need to use a catheter after bladder Botox?
Some patients need a catheter because the bladder does not empty well after treatment. Catheter use can last weeks or months. Your risk depends on your diagnosis and bladder function, so discuss this possibility before choosing Botox.
Can men get bladder Botox?
Yes. Overactive bladder affects millions of men, and Botox treats it the same way in both sexes. Men with an enlarged prostate or trouble emptying the bladder need that problem evaluated first, because Botox can make emptying harder.
Does insurance cover bladder Botox?
Coverage depends on your plan. Many insurers cover bladder Botox for overactive bladder after conservative treatments and medication have not worked, and many require approval in advance. Check with your plan about your deductible and any authorization it needs.
When can I schedule bladder Botox with Dr. Ferlic?
Contact the practice to ask which visit types are available and when in-person appointments and procedures can be scheduled.
Talk with the practice about bladder Botox
If medication hasn't controlled your overactive bladder, ask about other treatment choices. Call 435-344-4760 or send a message to discuss an evaluation and availability.
This page is for general education and is not medical advice.