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Thread: Intravesical Oxybutynin questions

  1. #1

    Intravesical Oxybutynin questions

    Most posts on this topic are pretty old. So I'll ask a few questions here. The cognitive side effects of all the bladder meds I've tried over the years just aren't worth it anymore. Botox injections on no meds only last about 1-2 months for me, and it's not practical or affordable that frequently. Oxybutynin has worked the best for me in the past, so I was curious about the process of instilling it into my bladder to reduce/eliminate the side effects. I will still do the botox injections as well, but hopefully this will allow me to extend them to every 3-6 months. So I have a few questions:

    1. Does anyone still do this?

    2. Any negative effects I need to be aware of?

    3. After cathing, what do I do about the urine that stays in the catheter? Push it back in with the solution, or take it out and use a new catheter for the oxybutynin?

    4. I took oxybutynin ER (15mg) once a day, so do I need to use the 5mg tablets instead so I can do this twice a day?



    Thanks in advance for any advice.

  2. #2
    I can't help you, unfortunately. But was curious - did you try Sanctura (trospium) ER 60mg instead of oxybutynin? Did you try it twice a day instead of once a day? Did that give you cognitive side effects? Like what?

    Also, did you try myrbetriq? That also failed?

  3. #3
    Will be curious to see if anyone is still doing this. It did cut down on the cognitive side effects, but with the newer medications out there, have seen this go by the way side.

    ckf
    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.

  4. #4
    Quote Originally Posted by hlh View Post
    I can't help you, unfortunately. But was curious - did you try Sanctura (trospium) ER 60mg instead of oxybutynin? Did you try it twice a day instead of once a day? Did that give you cognitive side effects? Like what?

    Also, did you try myrbetriq? That also failed?
    Yes, I have tried Trospium and Myrbetriq, as well as Vesicare (can't remember all the doses, sorry). Myrbetriq had the least amount of side effects (still not worth it) from everything I've tried over the years, but it was not as effective for the bladder issues as Oxybutynin.

  5. #5
    yes I do it in the evening at bedtime. 5 mg pill in 30 mL of saline. After I empty my bladder with the catheter and put in the solution using a syringe and keeping the plunger down and connected to the catheter, withdraw the catheter, leaving the solution inside.

    Does it help? I'm not sure. I've been doing it for years, my experience would mostly be anecdotal. It would be an interesting research project for a urological physician.

    I do Botox once a year, but after a couple months it wears off. I've been doing it for over a decade and I think its efficacy is declining. I have a bladder augment (about 12 years old)which was supposed to decrease my spontaneous contractions, but I wind up voiding out my umbilical stoma several times per day. It's a damn mess.

    In order for me to stay dry I would have to substantially restrict my water intake, which I am loath to do because of the mucus buildup from the augment, as well as the chronic infections I always have. I only drink water and I consume about, I would say, 2 1/2 liters per day.

  6. #6
    Quote Originally Posted by crags View Post
    yes I do it in the evening at bedtime. 5 mg pill in 30 mL of saline. After I empty my bladder with the catheter and put in the solution using a syringe and keeping the plunger down and connected to the catheter, withdraw the catheter, leaving the solution inside.

    Does it help? I'm not sure. I've been doing it for years, my experience would mostly be anecdotal. It would be an interesting research project for a urological physician.

    I do Botox once a year, but after a couple months it wears off. I've been doing it for over a decade and I think its efficacy is declining. I have a bladder augment (about 12 years old)which was supposed to decrease my spontaneous contractions, but I wind up voiding out my umbilical stoma several times per day. It's a damn mess.

    In order for me to stay dry I would have to substantially restrict my water intake, which I am loath to do because of the mucus buildup from the augment, as well as the chronic infections I always have. I only drink water and I consume about, I would say, 2 1/2 liters per day.
    Do you push the solution in before you remove the catheter you used to drain your bladder with, therefore pushing the urine left in the catheter back into your bladder with the solution? Or do you remove the catheter so there is no urine left and use a new one with the solution?

  7. #7
    I teach my patients to use the same catheter that they drained their bladder with. The amount of urine left in the catheter is very small and should not cause a problem. It is costly to use 2 catheters and in my opinion, not necessary if you drain the bladder appropriately.

    ckf
    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.

  8. #8
    yes, ditto. Do not use a second catheter. It is unnecessary, extra trauma, and just another opportunity to push bacteria into the bladder.

  9. #9
    One last question, when you push the oxybutynin solution into your bladder, I'm assuming all of it won't go through the catheter and there will be solution left in the catheter just like there is urine left when you drain your bladder correct? Is that ok that 100% of it doesn't go back in?

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