Concierge urology · London
Private bladder Botox in London, by a consultant urologist or urogynaecologist.
The NICE NG123 third-line treatment for overactive bladder that has not settled with bladder training, antimuscarinics or mirabegron — day-case, consultant-led, with CISC teaching built in.
Why patients choose us
- 01
A consultant urologist or urogynaecologist
Bladder Botox is a subspecialty procedure. We route you to a clinician who does dozens of these a year, not one who dabbles.
- 02
CISC teaching before, not after
You are taught clean intermittent self-catheterisation before the injection — so if your bladder temporarily struggles to empty, you are ready.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private bladder Botox costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A 100-unit bladder Botox cycle in our network: £2,000–£3,500, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Bladder Botox 100U (idiopathic OAB) | £2,000–£3,500 | 15–20 min | Same visit |
| Bladder Botox 200U (neurogenic detrusor overactivity) | £2,500–£4,000 | 20–30 min | Same visit |
| Under light IV sedation (add-on) | £400–£900 | Half-day | Same visit |
| CISC teaching session with specialist nurse | £150–£300 | 30–45 min | Same visit |
| Post-void residual & urodynamics assessment | £300–£700 | 45 min | Same visit |
| Urology or urogynaecology consultation | £250–£450 | 30–45 min | Same visit |
Prices vary by clinic, by which consultant does the case, by anaesthetic choice, and by whether a full urodynamic workup is added first. We come back with a firm quote within one working day.
The problem
The right specialist, the right dose, the right pathway.
Bladder Botox is only as good as the pathway that led to it. NICE NG123 is clear — conservative measures, then antimuscarinics, then mirabegron, then Botox or sacral nerve stimulation. We keep you on that pathway.
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Still leaking despite tablets?
If oxybutynin, solifenacin or mirabegron have not worked — or the side-effects were too much — third-line options open up.
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Worried about self-catheterising?
CISC is taught before the injection by a specialist nurse. Most patients never need to use it; you are simply prepared if you do.
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Want the pathway done properly?
A named consultant, a full NICE NG123-aligned assessment, and an honest comparison with PTNS and sacral nerve stimulation before you commit.
The journey
From enquiry to review — what happens, in order.
One clinician from first message to two-week check — including the residual measurement.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Urgency, leaks, frequency, nocturia, and what you have already tried — bladder training, antimuscarinics, mirabegron.
- 02
Before
We come back with a recommendation
Within one working day: whether Botox is the right third-line step per NICE NG123, or whether PTNS or sacral nerve stimulation fits better, and an indicative price.
- 03
Before
Pre-procedure work-up
A urine sample to rule out UTI, a post-void residual measurement, and a CISC teaching session with a specialist nurse. Any active infection is treated first.
- 04
On the day
Arrival at the clinic
Consent, a chat with the urologist, and the anaesthetic option that suits you — local anaesthetic instillation, or LA plus light sedation.
- 05
On the day
The injections themselves
A flexible or rigid cystoscope, 20–30 tiny injections of Botox into the bladder wall avoiding the trigone. Around 15 to 20 minutes in total.
- 06
On the day
Home the same day
A short recovery, written aftercare, a short course of antibiotic cover, and home within an hour or two.
- 07
After
Two-week residual check and review
Onset is 3–14 days, peak at 2–4 weeks. A post-void residual is measured at two weeks; if it is high, CISC covers you until your bladder recovers.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Peak effect: 2–4 weeks. Duration: 6–12 months.
When it helps
When bladder Botox is the right step.
The situations we see most, plus the one red flag that means a two-week-wait referral rather than a Botox booking.
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Refractory idiopathic OAB
Urgency, urgency incontinence, frequency and nocturia that have not settled with bladder training, antimuscarinics or mirabegron.
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Antimuscarinic side-effects
Oxybutynin, tolterodine, solifenacin, darifenacin, fesoterodine or trospium caused dry mouth, constipation or brain fog you could not tolerate.
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Mirabegron failed or unsuitable
The β3-agonist did not work, or blood pressure or other issues rule it out — bladder Botox is the next NICE-endorsed step.
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Neurogenic detrusor overactivity
Overactive bladder from multiple sclerosis, spinal cord injury, Parkinson’s or spinal dysraphism — treated with 200 units.
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Urgency-driven incontinence episodes
Sudden leaks with no warning, pad use through the day, or having to know where every toilet is on any journey.
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Waking three or more times a night
Nocturia that has wrecked your sleep and has not responded to fluid timing, evening restrictions or oral therapy.
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A prior good response to Botox
You have had bladder Botox before, it worked, and the effect is wearing off — a repeat cycle is typically due every 6–12 months.
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Red flag: visible blood or new pain
Visible blood in the urine, new pelvic pain, weight loss or a suspected pelvic mass is a two-week-wait referral, not a Botox booking.
Procedure options
Bladder Botox is not the only option.
What each option on the table actually involves — and which fits which type of overactive bladder.
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Botox 100U for idiopathic OAB
The standard licensed dose for OAB refractory to conservative measures and oral therapy — 20 injection sites of 0.5 ml each.
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Botox 200U for neurogenic OAB
The licensed dose for neurogenic detrusor overactivity in MS, spinal cord injury and related conditions — 30 injection sites of around 1 ml.
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Under local anaesthetic only
Intraurethral lidocaine gel and an instillation of anaesthetic into the bladder — awake, quick, and home within the hour.
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With light IV sedation
LA plus a small dose of sedation for patients who would rather not be fully aware — you will need someone to collect you.
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Repeat cycle (6–12 months)
Botox wears off. Most patients repeat the injection every 6 to 12 months on-demand as urgency returns — the same day-case set-up.
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Switch to Xeomin or Dysport
For the small group who develop reduced response over time, switching to a formulation without accessory proteins can restore effect.
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CISC teaching session
Clean intermittent self-catheterisation is taught before the injection — mandatory in case your bladder needs a hand emptying while Botox is at peak effect.
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Consultation only
An honest discussion of whether bladder Botox is the right next step, or whether PTNS or sacral nerve stimulation fits your case better.
Our vetted London network
A small panel of consultants, we picked them.
Consultant urologists and urogynaecologists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every consultant in our network.
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Consultant urologists or urogynaecologists who do bladder Botox as part of routine practice
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CISC teaching by a specialist continence nurse before the procedure
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Post-void residual measurement at two weeks — every patient, every cycle
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NICE NG123-aligned pathway: conservative → antimuscarinic → mirabegron → Botox or SNS
Safety and recovery
What to expect afterwards — honestly.
Bladder Botox is a well-established day-case treatment. The things worth planning are UTI risk, the small chance of needing CISC, and knowing what is normal after.
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UTI in around one in four
Urinary tract infection affects 20–30% after bladder Botox — usually mild, often prevented by a short course of prophylactic antibiotic on the day.
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Urinary retention needing CISC
Between 5–15% of OAB patients (and 20–30% with neurogenic OAB) temporarily cannot empty fully and need self-catheterisation until effect settles — usually within 3 months.
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Some blood in the urine is normal
Transient, mild haematuria for a day or two after the injections is universal and expected. Heavy or persistent bleeding is not — call the clinic.
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Discomfort during the injections
Local anaesthetic reduces this to a manageable level. Some patients feel pressure or a mild sting; sedation is an option if you would rather not be aware.
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Onset takes days, not hours
Effect begins at 3–14 days and peaks at 2–4 weeks. Duration is typically 6–12 months, then symptoms creep back and a repeat cycle is due.
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Very rare systemic spread
At bladder doses, systemic botulinum effects (muscle weakness elsewhere) are very rare. Allergic reactions are also very rare — Botox contains trace excipients.
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Reduced response over time
Under 5% develop antibodies that blunt the effect. Switching to Xeomin or Dysport, which lack accessory proteins, usually restores response.
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Who should not have it
Pregnancy or breastfeeding, active UTI (treat first), untreated retention, myasthenia gravis or other neuromuscular disease, unwillingness or inability to do CISC, and hypersensitivity to Botox.
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Red flags after the procedure
Fever, severe or spreading pelvic pain, inability to pass urine at all, or heavy visible bleeding are not normal — call the clinic or A&E the same day.
Reading your procedure note
Your procedure note in four parts. Read the last one first.
Whether the injection was for idiopathic OAB or neurogenic detrusor overactivity, the note the consultant sends you keeps to the same shape.
A quiet reminder
Urology notes are precise and can read coldly — we translate them for you.
If you would like us to talk you through the note before your two-week check, just ask.
- 01 Header
Indication and dose given
Whether the treatment was for idiopathic OAB (100 units) or neurogenic detrusor overactivity (200 units), and which oral therapies had already been tried.
- 02 Technique
Anaesthetic, scope and injection map
Whether it was done under LA or with sedation, the type of cystoscope used, and how many injection sites were placed across the detrusor.
- 03 Findings
Bladder appearance and trigone
Notes on the bladder lining, any incidental findings, and confirmation that the trigone was avoided to reduce the risk of reflux.
- 04 Impression
Onset, review and repeat plan
Read this first: when to expect effect, when the post-void residual check happens, CISC instructions if needed, and when a repeat cycle is likely to be due.
Recognised by major UK insurers
Cover for bladder Botox varies by insurer and by indication — usually funded when NICE NG123 criteria are met and prior therapies have failed. We confirm cover before booking.
Frequently asked
Everything we get asked about bladder Botox.
Quick answers on onset, duration, self-catheterisation, cost, and where it sits in the NICE pathway.
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What is bladder Botox and how does it work?
Small doses of onabotulinumtoxinA are injected into the bladder muscle (detrusor) through a cystoscope. It calms the overactive contractions that cause urgency, frequency and urgency incontinence. It does not shrink the bladder or numb it — it quiets the muscle for 6 to 12 months.
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Where does bladder Botox sit in the NICE pathway?
Under NICE NG123 (urinary incontinence in women, 2019), the sequence is: conservative measures (bladder training, pelvic floor, fluid management) → an antimuscarinic → mirabegron → and then third-line options: bladder Botox (100 units for idiopathic OAB) or sacral nerve stimulation. PTNS is also considered. Neurogenic OAB is treated at 200 units.
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How long does bladder Botox last?
Effect begins at 3 to 14 days, peaks at 2 to 4 weeks, and typically lasts 6 to 12 months. When urgency returns, a repeat cycle is arranged — most patients settle into a rhythm of one or two injections a year.
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Will I need to self-catheterise?
You are taught clean intermittent self-catheterisation before the procedure — this is mandatory. Around 5 to 15% of patients with idiopathic OAB (and 20 to 30% with neurogenic OAB) temporarily need to use it while Botox is at peak effect. It usually resolves within three months.
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How much does private bladder Botox cost in London?
Roughly £2,000–£3,500 for a 100-unit cycle (idiopathic OAB) and £2,500–£4,000 for 200 units (neurogenic OAB). Add £400–£900 for light sedation. We confirm a firm figure within one working day.
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What are the risks of bladder Botox?
The commonest issues are UTI (20–30%), temporary retention needing CISC (5–15% OAB, 20–30% NDO) and transient blood in the urine. Systemic Botox effects and allergic reactions are very rare. A very small proportion develop reduced response over time and switch to Xeomin or Dysport.
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Who should not have bladder Botox?
It is not offered in pregnancy or breastfeeding, in active UTI (treat first), in untreated urinary retention, in myasthenia gravis or other neuromuscular disease, if you cannot or will not perform CISC if needed, or if you are allergic to Botox or its excipients.
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When should I contact the clinic or A&E after the procedure?
Fever, severe or spreading pelvic pain, complete inability to pass urine, or heavy visible bleeding are not normal after bladder Botox and warrant same-day medical review.
Related tests
Looking for something else?
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Electrical stimulation of the pelvic floor
A non-surgical option earlier in the OAB pathway.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more -
Urology consultation
A named consultant urologist, in London.
Learn more -
Urogynaecology consultation
Specialist assessment for female incontinence.
Learn more