Concerning botulinum toxin (BT), it is important to check whether the patient presents lower urinary tract symptoms (LUTS), which are highly prevalent in MS. Intradetrusor BT injections may be indicated for refractory overactive bladder symptoms, such as urgency, frequency, and urgency urinary incontinence. In this setting, both aesthetic and therapeutic BT injections should be performed in the same week. Repeated injections should be avoided within the first 3 to 4 months after one treatment cycle.