Botox Injection For Neurogenic Bladder

Shawn · 05-02-2006, 08:48 AM

Hi

My Urologist just informed me that i should seriously consider botox injections as treatment for my neurogenic bladder because Ditropan isn't helping much. I would like to hear from other's here who have tried it and if it worked/helped or not? Comments from the SCI-Nurse will also be highly appreciated.

Kind Regards

Shawn

SCI-Nurse · 05-02-2006, 09:09 AM

This procedure is fairly new, and we are still not sure of the long term outcomes. Botox appears to be an option for those who have high pressures or leakage in spite of anticholinergic medications, and those who want to avoid having to have a bladder augmentation surgery.

The bladder is injected with Botox in multiple areas (up to 15) through a cystoscope. It is technically fairly easy to do, and takes about a hour. If it is going to be effective, results should be seen in about 2 weeks. It does not work for everyone, so augmentation surgery may need to be a back-up plan for some.

One downside of this is that you should expect to have to repeat the procedure every 6-12 months. Additionally, some people build up a resistance to Botox over time, so repeated injections may be less and less effective if this is the case for you.

Several people on these forums have had this done, and I am sure they can comment on their personal experiences with this.

(KLD)

Shawn · 05-03-2006, 02:49 AM

Thank you SCI-Nurse. I now eagerly wait to hear about other's personal experiences before i make my decision.

Solan · 05-03-2006, 03:44 AM

I had big problems with leakage before. Where I start leaking at 250-300ml and started getting botox injection in Aug.2004.
After about a week I closed the gate. And they are only open when an UTI comes knocking

.
So no more problems for 8 months(March 2005). Then it was time for a new injection. This time it lasted for 9 months(Dec. 2005) and I started to leak again on chrismas day at a family gathering. Bad timing

! I am now into my third run with botox and are currently having some problems with leakage, but I believe it is sphincter related and has nothing to do with the effect of Botox on my bladder. I'm seeing a specialist next week to find out more. But all in all I am happy with the effect Botox had on me.

If you have any more questions let me know.

And also I think I had 25-30 inj. into my bladder each run, so thats a bit more than SCI-nurse reported.

Belle · 05-03-2006, 09:44 AM

My husband has been having botox injections. The first series was I think in July of 2004. That lasted about 4 months. The second was in December of 2004, that lasted about nine months. The third was in September of 2005, and that has lasted about up to now (approx 7 mo). He's started leaking a little bit occasionally at night, so he has scheduled another treatment for mid-May. It's outpatient, all you have to do is be able to remove the foley the next day.

Overall, for him it works very well. He considers it his #1 quality of life enhancement. He does leak a little sometimes when he gets uti's, but fortunately he only gets those once or twice a year. It is also easier on his bladder when he drinks less soda - he used to drink it almost by the 2-liter, but is currently down to about 20 oz a day. The caffeine and possibly other components seem to bring on large, erratic volumes. He's always better when he's off of it, but for him it's like quitting smoking - just can't seem to stay off the stuff!

Without the botox, he was miserable on really high doses of anticholinergics, and still leaking. It has always been worse at night, but it got to where he'd leak sometimes during the day as well. His urologist suggested the botox right away, and it's been quite manageable since then. I also think it was more injections, like 30 or so, if I recall correctly.

tegdirb · 05-03-2006, 03:19 PM

I'm considering this also...does anyone know the risks and side effects or have experienced any?

LBUSH49 · 05-03-2006, 07:38 PM

Hi ,I wasn't so lucky I had 15 injections and it didn't help me ,but I have a lot of other problems too , but I do want to wish you good luck and I hope they work for you . LBUSH

Shawn · 05-04-2006, 04:16 AM

The replies thus far are appreciated. Please note that i void on my own, i.e. no catherization. Will i still be able to void on my own after using Botox or, will i have to start using a catheter?

Solan · 05-04-2006, 08:30 AM

That might be more difficult. The Botox, as I understand it, paralyses the muscles around/in the bladder, so you are not able to contract the bladder by naturall means anymore. So even though you are able to open the sphincer I don't think you can empty the bladder. Thats my understanding anyway.

Quote:

Originally Posted by Shawn

The replies thus far are appreciated. Please note that i void on my own, i.e. no catherization. Will i still be able to void on my own after using Botox or, will i have to start using a catheter?

SCI-Nurse · 05-04-2006, 08:42 AM

Solan is correct. This procedure is designed to paralyze your bladder. Intermittent catheterization is required to empty the bladder with this procedure.

Bridget, several of the VA SCI Centers are starting a large research study regarding bladder Botox for people with SCI. You may want to inquire if the one where you get your care is one of these centers.

(KLD)

05-03-2006, 09:44 AM	#5
Belle Senior Member Join Date: Jun 2004 Location: NW Ohio Posts: 498	botox My husband has been having botox injections. The first series was I think in July of 2004. That lasted about 4 months. The second was in December of 2004, that lasted about nine months. The third was in September of 2005, and that has lasted about up to now (approx 7 mo). He's started leaking a little bit occasionally at night, so he has scheduled another treatment for mid-May. It's outpatient, all you have to do is be able to remove the foley the next day. Overall, for him it works very well. He considers it his #1 quality of life enhancement. He does leak a little sometimes when he gets uti's, but fortunately he only gets those once or twice a year. It is also easier on his bladder when he drinks less soda - he used to drink it almost by the 2-liter, but is currently down to about 20 oz a day. The caffeine and possibly other components seem to bring on large, erratic volumes. He's always better when he's off of it, but for him it's like quitting smoking - just can't seem to stay off the stuff! Without the botox, he was miserable on really high doses of anticholinergics, and still leaking. It has always been worse at night, but it got to where he'd leak sometimes during the day as well. His urologist suggested the botox right away, and it's been quite manageable since then. I also think it was more injections, like 30 or so, if I recall correctly. __________________ ************* AB wife of T8 complete para

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05-02-2006, 08:48 AM	#1
Shawn Senior Member Join Date: Jul 2001 Location: South Africa Posts: 284	Botox Injection For Neurogenic Bladder Hi My Urologist just informed me that i should seriously consider botox injections as treatment for my neurogenic bladder because Ditropan isn't helping much. I would like to hear from other's here who have tried it and if it worked/helped or not? Comments from the SCI-Nurse will also be highly appreciated. Kind Regards Shawn

05-02-2006, 09:09 AM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,515	This procedure is fairly new, and we are still not sure of the long term outcomes. Botox appears to be an option for those who have high pressures or leakage in spite of anticholinergic medications, and those who want to avoid having to have a bladder augmentation surgery. The bladder is injected with Botox in multiple areas (up to 15) through a cystoscope. It is technically fairly easy to do, and takes about a hour. If it is going to be effective, results should be seen in about 2 weeks. It does not work for everyone, so augmentation surgery may need to be a back-up plan for some. One downside of this is that you should expect to have to repeat the procedure every 6-12 months. Additionally, some people build up a resistance to Botox over time, so repeated injections may be less and less effective if this is the case for you. Several people on these forums have had this done, and I am sure they can comment on their personal experiences with this. (KLD)

05-03-2006, 02:49 AM	#3
Shawn Senior Member Join Date: Jul 2001 Location: South Africa Posts: 284	Thank you SCI-Nurse. I now eagerly wait to hear about other's personal experiences before i make my decision.

05-03-2006, 03:19 PM	#6
tegdirb Senior Member Join Date: Mar 2003 Posts: 1,123	I'm considering this also...does anyone know the risks and side effects or have experienced any?

05-03-2006, 07:38 PM	#7
LBUSH49 Senior Member Join Date: Nov 2005 Location: NEW HAMPSHIRE Posts: 1,090	Hi ,I wasn't so lucky I had 15 injections and it didn't help me ,but I have a lot of other problems too , but I do want to wish you good luck and I hope they work for you . LBUSH

05-04-2006, 04:16 AM	#8
Shawn Senior Member Join Date: Jul 2001 Location: South Africa Posts: 284	The replies thus far are appreciated. Please note that i void on my own, i.e. no catherization. Will i still be able to void on my own after using Botox or, will i have to start using a catheter?

05-04-2006, 08:42 AM	#10
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,515	Solan is correct. This procedure is designed to paralyze your bladder. Intermittent catheterization is required to empty the bladder with this procedure. Bridget, several of the VA SCI Centers are starting a large research study regarding bladder Botox for people with SCI. You may want to inquire if the one where you get your care is one of these centers. (KLD)