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    Intravesical Botox Injections

    Hey Folks....I haven't been around here long and can't find any mention of anybody here having these injections.....in the bladder. Not that I've got a wrinkly bladder. Some months after leaving the spinal unit I started peeing my tweeds on a regular basis. All manner of drugs were tried and although there was limited sucess it was not enough to guarantee dry pants between caths. My urologist mentioned this procedure which is done under a local anasthetic, not that I could feel anything, but he didn't want an spasm to result in my foot in his mouth. Botox is injected into the bladder wall in approx 32 different spots. In effect this paralyses the bladder and prevents bladder spasm and the subsequent involuntary emptying of the same. I have had 2 procedures, the first one lasting 8 months, the secong lasting 9 months. I am due to go in for my 3rd procedure any day now.

    It works a treat and for some reason I don't get bladder infections at all until the botox wear off....apart from the intermittent appearance of a map of Australia on my pants, another sign the botox is wearing off is the return of bladder infections...Damned if me and the Dr can figure out what/where/how/why the infections and the botox are linked...but they certainly seem to be...

    I have also noticed that my bladder has a sensitivity to coffee when the botox is nearing the end of its effect. Have a cup of coffee and it irritates the bladder and out she comes...Quite common I'm lead to believe..

    The botox is hoped to have a building up effect, in that it lasts longer and longer the more often the procedure is performed...

    Anyway, my question/s..
    1. Does anybody else here have this procedure?
    2. Has anybody else suffered from drink coffee/pee your pants syndrome?
    3. Does anybody have any thoughts on the botox/bladder infection scenario or is it possibly just a coincidence?

    Great little community here guys....I hope to hang around in here for a while

    Take Care

    Shayne
    HERE FOR A GOOD TIME , NOT A LONG TIME

    #2
    of course...coffee makes my life misrable, i have to go to bathroom like million times to avoid accident but I'm a coffee freak and still drinking it..lol

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      #3
      Hey Wheelie Girl...I completely understand your enthusiasm for coffee...I need at least one decent cup a day.......
      HERE FOR A GOOD TIME , NOT A LONG TIME

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        #4
        Caffeine is notorious for causing bladder irritability, which increases incontinence for many. Try cutting out caffeine (coffee, black tea, sodas with caffeine) and see if this does not help.

        It is not surprising that your UTIs increase when your Botox wears off. It is well known that high bladder pressures are one of the major factors in causing UTIs in people with SCI.

        The only other option at this point is to do the Botox injections more often (so they don't wear off completely before being redone), or consider a bladder augmentation surgery (big surgery, but helpful for many in this area).

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #5
          Originally posted by SCI-Nurse
          Caffeine is notorious for causing bladder irritability, which increases incontinence for many. Try cutting out caffeine (coffee, black tea, sodas with caffeine) and see if this does not help.

          It is not surprising that your UTIs increase when your Botox wears off. It is well known that high bladder pressures are one of the major factors in causing UTIs in people with SCI.

          The only other option at this point is to do the Botox injections more often (so they don't wear off completely before being redone), or consider a bladder augmentation surgery (big surgery, but helpful for many in this area).

          (KLD)
          What does this bladder augmentation surgery do.....????? if you don't mind me asking. Thanks
          HERE FOR A GOOD TIME , NOT A LONG TIME

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            #6
            An augmentation cystoplasty is a big procedure. They take about 2 feet of your large intestine (with the blood vessels still attached), cut it lengthwise, and fashion it into a dome shape. They then cut through the top half of your bladder, laying it open, and then sew this patch of bowel into place. This both makes the bladder bigger, and disrupts the bladder muscle so it can't contract as well, lowering bladder pressures. It is a 10 day to 2 week hospitalization usually. It is a last ditch procedure, but I have seen it make all the difference in quality of life for many people with SCI who have failed medications. We did more of them before we had Botox, but even now, if Botox fails, it is considered the next step.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

            Comment


              #7
              I tried the botox injections 3 times. My bladder was only holding about 4 oz before I had to go RIGHT NOW! The first time it worked great. The second time, I got a UTI and that was it for the botox - it quit working right there. The third time it didn't work nearly as well.

              So I went ahead with the bladder augmentation. It's been a year now and has been a LIFE SAVER! After I drink my coffee in the morning I can only go about 45 minutes before I have to hit the bathroom. After that I can go anywhere from 4 - 6 hours without going. I haven't measured lately but at my last urologist visit I held 10 oz before my bladder spasms started. I no longer have to sleep in diapers. I can sleep up to 8 hours without having to go and now I feel the urge and am able to get up and go when it does hit during the night.

              IT was a hell of a surgery but I am so happy I went through with it. I finally last weekend gave away the 50 packages of diapers that I had kept "just in case". That surgery has definitely made my quality of life 100% better. IF your whole life revolves around finding a bathroom in time then I definitely suggest having the surgery.

              Good Luck. I hope you find something that works!
              Tina
              C5-C7 Walking Quad - Very Incomplete
              Aug '03

              Comment


                #8
                TinaMarie

                Thank you for the information..Sounds like the op was a major deal, but well worth the hassle. I'm going to do a bit more research on it and keep it in my armoury just in case.....It also lets my urologist know I haven't just been sitting on my backside waiting for him to supply all the answers..Thanks again
                HERE FOR A GOOD TIME , NOT A LONG TIME

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                  #9
                  Now I get , I never knew Intravesical Botox Injections , thank very much for sharing to everybody i love botox.

                  Comment


                    #10
                    regarding augmentation:

                    "disrupts the bladder muscle so it can't contract as well"

                    that's a goal, but a significant percentage of folks (don't know the exact #) still have contractions after the surgery, though they may be weaker.

                    that's why i do botox 1x/year, under mild sedation to prevent AD

                    never do botox in an office w/o anesthesia

                    did it once and was very frightened, i felt a stroke could have been not far away if he hadn't finished, took it right to the edge

                    bad move on my part, bad judgement on the md's part

                    Comment


                      #11
                      Anytime I drink a carbonated beverage, whether it has caffiene in it or not, I have accidents for hours.

                      Botox combined with Toviaz pills has helped with the daytime accidents, but nothing has helped the nighttime accidents, and my uro told me that there isn't much left he can do, especially since I am getting 900mls of fluid put through me via feeding pump every night. That's like drinking a glass of water every 2-3 hours during the middle of the night. My uro told me that if the Botox and Toviaz decide to fail after a while, he'd recommend a urostomy for me, since I do not have a large intestine anymore. He said that it would be too big of a risk for short bowel syndrome if he used my small intestine for an augmentation.

                      Jessie

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                        #12
                        Originally posted by crags View Post
                        never do botox in an office w/o anesthesia

                        did it once and was very frightened, i felt a stroke could have been not far away if he hadn't finished, took it right to the edge

                        bad move on my part, bad judgement on the md's part
                        I don't think that is universally true.

                        I had botox done for the first time, and they wanted to put me out, but I convinced them to just put the IV in and they can hit me with anesthesia if something starts to go wrong. It went by like a breeze (well as breezy as anything can go with a half dozen people poking things into your penis).

                        Next time I will defnitiely try to do it at the Drs Office. That will save several hours of waiting, and loads of money I imagine.

                        Comment


                          #13
                          Christine

                          I have MS and part of my symptoms is an unstable bladder.

                          Initially I could control this with intermittent self catheterisation.

                          However this became impossible so many years later I had a supra-pubic catheter fitted under a general anaesthetic.

                          Recently my bladder was starting to spasm which meant that my catheter could'nt drain away the urine fast enough which meant I had frequent accidents.

                          My Uru-Gynaecologist suggested intravesical botox and I had this done under general anaesthetic last Friday, 3rd September 2010.

                          I am pleased to say that this has stopped my spasms and I haven't had an accident since.

                          I don't know how long it will last as I understand it needs to be done repeatedly every 6 - 9 months.

                          Will keep you informed!

                          Comment


                            #14
                            Originally posted by anastacia49 View Post
                            I don't know how long it will last as I understand it needs to be done repeatedly every 6 - 9 months.]
                            Mine lasted about 5 months. I really really like botox, but I don't know if I am going to do it again. The main reason is that I can't get an appointment for another injection for 3 months. So it has to stop working, then I have to get an appointment to be evaluated, then I have to get an appointment for the procedure, then I'm messed up for a week and half after the procedure. It's not really a fix, with all the down time between when it stops working and when you can get it again, it is pretty much half on half off for me, so I might as well not spend all that money on it...

                            kinda frustrating since it works really good with no side effects, but I guess they won't let you schedule these things ahead of time.

                            Comment


                              #15
                              There are dozens of posts on this website about bladder botox injections and you can read them by searching this site for "bladder botox."

                              I had bladder botox injections 4 times. The first time worked great for about 8 months. (I don't drink coffee or caffeinated beverages so I don't have experience to share with you there). The next botox procedure effects lasted for about 5 months, and treatments 3 and 4 were minimally, if at all effective.
                              I have not heard anyone speak, nor have I read any reports of the effects of bladder botox building up over time, much to the contrary.

                              I too was faced with taking the next step in bladder management, and ileovesicostomy and Mitrofanoff procedures with or without bladder augmentation were discussed and strongly promoted by the neurogenic urology surgeon with whom I consulted . These are very BIG surgeries. I preferred to take a "baby steps" approach, suggested by my primary care physician and general urologist to finding a new bladder management method by getting a supra pubic catheter (SP). This is a simple and reversible procedure. The SP procedure is done in an out patient setting. A puncture/incision just above the pubic bone through the abdomen to the bladder creates a stoma. A foley catheter is used to drain urine into a lower leg, thigh, or belly bag. I had the SP inserted at the end of June 2010 and have never looked back. If someday, this is no longer working for me and I have to face a bigger procedure, I still have that as an option. But, for now, I am perfectly happy with the results and new found freedom from, what was for me, numerous catheterizations every day around the clock, interrupting my daily activities and sleep.

                              All the best,
                              GJ
                              Last edited by gjnl; 18 Jan 2011, 4:58 PM.

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