Under active bladder

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tomcat

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  1. Incontinent
Been diagnosed with under active bladder and urologist next month is giving me Botox at the prostate and urethral sphincter.

Has anyone had this done

as it is I tend to store 800 -1200mls before I feel it if I don’t have overactive symptoms that day.

my private continence nurse and public health urologist has divided me on different treatment plans as urologist refuses to communicate with continence nurse
 
I have a neurogenic bladder that is underactive (atonic) with occasional bouts of spasming. It has a capacity of 2000 ml. Meanwhile, I have a urethral sphincter that is typically weak due to a genetic disorder. I only have the one sphincter as a result of radical prostatectomy. My genetic disorder can also cause severe rigidity (spasticity) which causes the sphincter to lock closed, causing severe retention and requiring Foley catheterization until the rigidity passes. So, even though I deal with incontinence almost constantly, I maintain a voiding schedule to empty the bladder (I use the toilet) and perform intermittent self catheterization four times daily to remove residual urine from my non-working bladder.

I am well aware of the use of Botox for OAB, but was surprised when you said you are scheduled for Botox injections at the sphincter sites. This caused me to do a little research.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3651538/
https://www.urineincontinence.com.au/other/underactive-bladder
https://bladderclinic.com.au/conditions/bladder/underactive-bladder

Botox injections at the sphincter sites is a recent development to help with OAB in multiple sclerosis and spinal cord patients who frequently develop neurogenic detrusor overactivity.
https://pubmed.ncbi.nlm.nih.gov/25042138/

This in turn caused me to go look at your profile and early posts, and there I found out you are a spinal cord patient! So it seems your urologist is on top of the latest treatments. I hope you see great benefit from the Botox treatment. If you do, maybe it will help get your continence nurse and urologist to communicate on your treatment.
 
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How often will you need Injections?
My urologist Explained if I went that route it be every 3-4 months
just curious what others situations would be
 
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With all my issues (as I feel my bladder has a mind of its own and I am a control freak and OCD which I have been told is part of my Autism) wish he would do a semi-permanent thing to make me completely urinary incontinent to the point I even stated it to him even if it was to make me leak while I sleep as it is affecting my Chronic Fatigue waking up 5+ times per night and falling down going to the bathroom at least once per week.

I have even stated this to my Psychiatrist ( I see for my Autism, Bipolar and ADHD) who read one of the urologist reports (only one referring GP has gotten so far) he understands that there is obstruction and that medications do not work for me as I have trialed even according to Urologist report
 
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I had some problems with this before I developed OAB years ago. I have autism and was holding on to my wee too long due to problems with interoception and damaged some of the nerves in my bladder. Sometimes my bladder would get so full I couldn’t wee at all and would have to front up at the ER to be catheterised. Things ended up going in the opposite direction after a couple of years when I developed OAB wet and haven’t had problems with under activity since.
 
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I have no experience with either what you are experiencing or with the recommended treatment (Botox).
I would strongly recommend that you follow CheshireCat recommendation.

That said, Botox, per my Urologist is still experiment and injects have to be precise.

Please keep us updated!
 
Good luck to you. My bladder does not empty correct and about 20 plus years ago I could store around 1600ml. It is very dangerous to your kidneys if you do not take care of it. I use CIC and also over the years my IC got so bad I cant hold much when I get a urge but I can still retain up to 200ml.

I never done the botox injections but I do know it only last 10-90 days maybe longer depending on the person but is not a real preeminent fix . @Pino is a good person to talk too he can give you a really good rundown what to expect.
 
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Well, this kind of Botox injection maybe different, i do get mine into the bladder wall, he is getting them into the sphincter, that's a "different construction site", as we quote in German. I am not sure, but think this type of injection is done with anesthesia.

Why is ISC not an option? @tomcat
 
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Pino said:
Well, this kind of Botox injection maybe different, i do get mine into the bladder wall, he is getting them into the sphincter, that's a "different construction site", as we quote in German. I am not sure, but think this type of injection is done with anesthesia.

Why is ISC not an option? @tomcat
Click to expand...
Indwelling Cath is still on the tables if this fails but urologist wants to trial this due to risk of UTIs apparently
 
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