to Botox or not to Botox: that is my question?

[jennypenny]

I?ve had bladder leakage on and off for years-no rhyme or reason. Don?t want to be on mind-altering drugs again or switch from my SP tube to in/out cathing.

Was just tested for stones of all kinds and all is clear. My urologist is convinced that Botox is the option I need, and my physiatrist agrees.

I?m hesitating because the information I?ve read indicates that this treatment is mostly done to in/out cathing patients because it doesn?t allow the bladder to empty completely, leaving them more likely to get bladder infections (and I don't completely understand this statement).

I?d love for this to be an option for me if it?s safe?anyone out there have good experiences w/this?

[SCI-Nurse]

Botox is an option for those with indwelling catheters that cannot take or cannot tolerate the side effects of the anticholenergic meds (like Ditropan, Detrol, etc.), but you need to know that the treatment does not last for ever (6-18 months depending on the individual) so may need to be done repeatedly, and for some people, it is less and less effective with each course of treatment.

Lots of people on these forums have had bladder Botox. You are correct that most who have it have to prevent leakage and lower too high bladder pressures in those who use intermittent cath for bladder management, but it can and is also used to treat bladder spasm and leakage due to bladder spasm for those who use indwelling catheters.

(KLD)

[jennypenny]

Botox is an option for those with indwelling catheters that cannot take or cannot tolerate the side effects of the anticholenergic meds (like Ditropan, Detrol, etc.), but you need to know that the treatment does not last for ever (6-18 months depending on the individual) so may need to be done repeatedly, and for some people, it is less and less effective with each course of treatment.

Lots of people on these forums have had bladder Botox. You are correct that most who have it have to prevent leakage and lower too high bladder pressures in those who use intermittent cath for bladder management, but it can and is also used to treat bladder spasm and leakage due to bladder spasm for those who use indwelling catheters.

(KLD)

is the term "bladder pressures" related to bladder retention? and how does retaining too much urine cause a bladder infection? there's so much to learn about how the bladder works.

[SCI-Nurse]

Not directly related.

The bladder pressure can only be measured during a urodynamics study. It is the pressure of the urine against the walls of the bladder. High pressures (over 40 cm. H20) can cause damage to the bladder wall, reflux and hydronephrosis, are associated with long term damage to the kidney, and can increase the risk for true UTI (not just colonization).

Retention the term used to describe urine remaining in the bladder, either after a void or cath or that is not being drained by an indwelling catheter. Retention or urine left behind after voiding or cathing becomes a reservoir for infection, and can also cause increased bladder pressures, which can both damage the bladder muscle, and cause reflux (backflow of urine up the ureters to the kidney). Retention or over-filling of the bladder (usually defined as more than about 450ml.) is associated with both reflux and increased risk of infection as it decreases the blood flow to the bladder walls and mucosa.

(KLD)

[jennypenny]

Not directly related.

The bladder pressure can only be measured during a urodynamics study. It is the pressure of the urine against the walls of the bladder. High pressures (over 40 cm. H20) can cause damage to the bladder wall, reflux and hydronephrosis, are associated with long term damage to the kidney, and can increase the risk for true UTI (not just colonization).

Retention the term used to describe urine remaining in the bladder, either after a void or cath or that is not being drained by an indwelling catheter. Retention or urine left behind after voiding or cathing becomes a reservoir for infection, and can also cause increased bladder pressures, which can both damage the bladder muscle, and cause reflux (backflow of urine up the ureters to the kidney). Retention or over-filling of the bladder (usually defined as more than about 450ml.) is associated with both reflux and increased risk of infection as it decreases the blood flow to the bladder walls and mucosa.

(KLD)

good to know. thanks!

urodynamics is done on a person w/what type of bladder management?

and what would prevent an indwelling catheter from draining completely? could a botox treatment cause this?

[SCI-Nurse]

Urodynamics is done for most people with SCI/D and neurogenic bladder, but really is not warranted for those who use a permanent indwelling catheter, nor of course for those without a bladder (urinary diversion or urostomy).

An indwelling catheter that does not drain fully is usually clogged, although large bladder diverticuli may also be the culprit.

(KLD)

[jennypenny]

Urodynamics is done for most people with SCI/D and neurogenic bladder, but really is not warranted for those who use a permanent indwelling catheter, nor of course for those without a bladder (urinary diversion or urostomy).

An indwelling catheter that does not drain fully is usually clogged, although large bladder diverticuli may also be the culprit.

(KLD)

so, I'm confused...in general, one w/a SP tube doesn't really need this test becuz their bladder drains efficiently, w/the exception of, of course, clogging and (what are bladder diverticuli?)