As of 2/2013, botox is now an FDA approved treatment for overactive bladder (OAB) and it’s associated symptoms: urinary urgency, urinary frequency and urge incontinence. These urinary symptoms may also occur with interstitial cystitis. Recommendations are to try conservative measures first, like medications, dietary changes, and/or pelvic floor therapy, biofeedback, electronic stimulation. Once conservative measures fail, botox is injected under direct visualization through a small long needle that is placed into a small camera (cystoscope). A series of 10-20 injection sites are mapped through out the bladder. This is easily done In the office with some lidocaine infused into the bladder as a numbing agent. The whole procedure can be 5-10 minutes. Success rates are 70-80% and can start just a few days after injection. Botox can last from 3-10 months depending on the dose and the individual. There are 2 doses of botox. The 100 unit dose has a 4-6% risk of retention, which means a patient may have to catheterize for awhile to urinate. The higher dose of 200 unit dose can have a longer lasting effect of up to 10 months but the risk of retention is also higher. Botox Is a nice minimally invasive office procedure that is not an irreversible surgery.