botox in bladder

[Hope2005]

I had 300 units of botox injected in my bladder yesterday to help control spasms that I have been having. I self cath and am experiencing a good bit of bleeding when cathing. Anyone else have problems cathing after this procedure? And if you have had procedure, has it been productive for you?

[gjnl]

Hi "Hope"
I have had Botox 4 times. Yes, each time, I experienced a bit of bleeding for a couple days after the injections. Your bladder is poked with a needle a number of times (a lot) in the process and it has to be a bit raw and tender. If you are still having a problem in a few days, call the urologist. Just an outside chance question...are you on anticoagulants? If you are and didn't stop them before the treatments, that could cause more of a bleeding problem.

I had 300 units of Botox each time I had the treatment. The first two times, I had excellent results and was very pleased that my bladder could hold between 450 and 550 ml between catheterizations. My third treatment was okay, but I was only holding between 350 and 400 mil between caths, and it didn't last as long as the first two treatments. The fourth treatment was completely useless. I didn't experience any effects from the fourth one at all. It was basically like I hadn't had the treatment at all.

All the best,
GJ

[Hope2005]

Originally Posted by gjnl

Hi "Hope"
I have had Botox 4 times. Yes, each time, I experienced a bit of bleeding for a couple days after the injections. Your bladder is poked with a needle a number of times (a lot) in the process and it has to be a bit raw and tender. If you are still having a problem in a few days, call the urologist. Just an outside chance question...are you on anticoagulants? If you are and didn't stop them before the treatments, that could cause more of a bleeding problem.

I had 300 units of Botox each time I had the treatment. The first two times, I had excellent results and was very pleased that my bladder could hold between 450 and 550 ml between catheterizations. My third treatment was okay, but I was only holding between 350 and 400 mil between caths, and it didn't last as long as the first two treatments. The fourth treatment was completely useless. I didn't experience any effects from the fourth one at all. It was basically like I hadn't had the treatment at all.

All the best,
GJ

Thank you for your help and your sharing your experience with me. I am not taking anything to thin my blood, and did not at the time of the procedure, so that part shouldn't interfere with bleeding. It has tapered off a but this evening, so I am praying that it will continue to do so.

The research that I have looked into regarding botox is pretty typical for what you described... eventually the bladder becomes resistant. How much time between your first and last treatment was there?

Sincerely

[gjnl]

Originally Posted by Hope2005

The research that I have looked into regarding botox is pretty typical for what you described... eventually the bladder becomes resistant. How much time between your first and last treatment was there?

I got about nine months (each) out of the first two, and 4-5 months out of the third, nothing out of the fourth. So, I guess, about 22 months.

Take care,
GJ

[Hope2005]

Originally Posted by gjnl

I got about nine months (each) out of the first two, and 4-5 months out of the third, nothing out of the fourth. So, I guess, about 22 months.

Take care,
GJ

Thank you once again. It really helps to seek advice and opinions from others who have experinced life as we know it, and not just a doctor.

Take care and God bless,

Hope
"We do not remember the days, we remember the moments..."

[stephen212]

Originally Posted by gjnl

I got about nine months (each) out of the first two, and 4-5 months out of the third, nothing out of the fourth. So, I guess, about 22 months.

Take care,
GJ

What explanation were you given for the lack of results from the fourth procedure?

[gjnl]

In some people, the body will develop antibodies to the Botox, a purified protein. Urologist should try to use the least amount of Botox to be effective to minimize the the development of the resistance. 300 units seems to be a pretty standard amount for bladder sphincter dyssynergia and neurogenic bladder.

GJ

[stephen212]

http://emedicine.medscape.com/article/1271380-overview

Immunologic Considerations

An estimated 5-15% of patients injected serially with 79-11 BOTOX® developed secondary nonresponsiveness from the production of neutralizing antibodies. Risk factors associated with the development of neutralizing antibodies include injection of more than 200 units per session and repeat or booster injections given within 1 month of treatment. The newer BCB 2024 BOTOX® appears to have a lower potential to induce antibody production because of its decreased protein load. In rabbit studies, no antibody formation occurred with new BOTOX® after 6 months of treatment, while 79-11 old BOTOX® caused antibody formation in all rabbits by 5 months. Recent studies by Dressler et al suggest that the rate of developing neutralizing antibodies is substantially reduced with BSB 2024.14 In addition, Jankovic reported that the new formulation of BOTOX® reduced the frequency of antibodies 6-fold.15

Some patients injected for cosmetic purposes develop neutralizing antibodies. When a patient loses his or her response, serum can be tested for neutralizing antibodies, although this rarely is performed outside research settings. Alternatively, a patient's physiologic response can be evaluated with a single injection of 15 units into the frontalis on one side.

Limited information is available as to whether neutralizing antibodies resolve over time and, consequently, whether attempts at reinjection should be made after a prolonged period. Using the lowest dose of toxin necessary to achieve the desired clinical effect and avoiding reinjection within 1 month appear prudent in an effort to keep antibody formation as low and unlikely as possible.

[gjnl]

Originally Posted by stephen212

Limited information is available as to whether neutralizing antibodies resolve over time and, consequently, whether attempts at reinjection should be made after a prolonged period. Using the lowest dose of toxin necessary to achieve the desired clinical effect and avoiding reinjection within 1 month appear prudent in an effort to keep antibody formation as low and unlikely as possible.

The problem is that many who develop the antibodies and thus a resistance to Botox and who have bladder sphincter dyssynergia and/or neurogenic bladder can't wait long enough (not talking one month) after four or so treatments to see if the resistance goes away. As an example...when the fourth treatment did not work, my bladder could not hold more than 200 ml of urine, which means I was having to cath 8 to 12 times per day (24 hour period). You can't live a life or get any sleep on that schedule. In my opinion, Botox has its place in the scheme of things, and provides a stop gap measure to the next step of bladder management.

All the best,
GJ

[stephen212]

Originally Posted by gjnl

The problem is that many who develop the antibodies and thus a resistance to Botox and who have bladder sphincter dyssynergia and/or neurogenic bladder can't wait long enough (not talking one month) after four or so treatments to see if the resistance goes away. As an example...when the fourth treatment did not work, my bladder could not hold more than 200 ml of urine, which means I was having to cath 8 to 12 times per day (24 hour period). You can't live a life or get any sleep on that schedule. In my opinion, Botox has its place in the scheme of things, and provides a stop gap measure to the next step of bladder management.

All the best,
GJ

Ugh, the next step. And if that's bladder augmentation then I'll have to consider getting a suprapubic. But I've only had 2 Botox treatments so far and the last one was 15 months ago. I'll probably get re-injected in December and keep my fingers crossed that I get as much mileage from it.