Complications of Botox and their Management

Adherence to anticholinergic medications is known to be a problem in patients with overactive bladder, with only 13.2% of patients continuing anticholinergic therapy beyond 1 year D'Souza et al. (J Manag Care Pharm. 14:291-301, 2008).

Prior to the advent of third line therapies such as onabotulinumtoxin A, refractory overactive bladder (OAB) was managed with augmentation cystoplasty, a lengthy surgery with associated side effects including lifetime need for self-catheterization, ileus, and metabolic disturbances. The advent of onabotulinumtoxin A has drastically reduced the rates of augmentation cystoplasties being performed for refractory OAB. However, all procedures are associated with side effects which should be relayed to the patient prior to beginning therapy, as well as their management. In the current review, we summarize the common complications following onabotulinumtoxin A injection as well as their management.