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  • Botox found to be helpful in patients with overactive bladder

    Role of botulinum toxin-A in refractory idiopathic overactive bladder patients without detrusor overactivity. - Abstract
    Tue, 14 June 2011

    Department of Urology, University of Miami-Miller School of Medicine, 1150 NW 14 Street, Suite 309, Miami, FL, 33136, USA.

    To evaluate the efficacy of intradetrusor botulinum toxin-A (BTX-A) in idiopathic overactive bladder patients (OAB) refractory to anti-muscarinic therapy, without detrusor overactivity (DOA) on urodynamics.

    Patients with refractory idiopathic OAB without DOA on urodynamics were prospectively enrolled. Subjects completed a 3-day voiding diary (3-VD), urogenital distress inventory-6 questionnaire (UDI-6) and graded their quality of life on a 10-cm visual analog scale (VAS) prior to study enrollment and at week 12 postinjection. All patients underwent multichannel urodynamics at study enrollment and 12 weeks postinjection. Improvement was analyzed based on 3-VD, UDI-6 questionnaire, VAS scores, and urodynamic parameters at week 12 postinjection compared to study enrollment.

    The study included 32 patients. Mean ± SD age was 56 ± 16. There were 27 women and 5 men. Nineteen patients had OAB without incontinence (OAB-dry) and 13 patients had OAB with incontinence (OAB-wet). In OAB-dry patients, mean ± SD urinary frequency dropped from 24 ± 11 to 10 ± 4 by week 12. In OAB-wet patients, mean ± SD urge incontinence episodes dropped from 7.9 ± 5 to 0 ± 2.6 by week 12. Mean UDI-6 and VAS scores improved significantly in both groups by week 12 (P = 0.0001). On comparing urodynamic parameters, OAB-wet patients showed significant decrease in maximum detrusor pressure during the voiding phase at week 12 compared to baseline values (P = 0.02).

    Refractory idiopathic OAB patients without DOA on urodynamics may benefit from intradetrusor BTX-A.

    Written by:
    Kanagarajah P, Ayyathurai R, Caruso DJ, Gomez C, Gousse AE.

    Reference: Int Urol Nephrol. 2011 Jun 4. Epub ahead of print.
    doi: 10.1007/s11255-011-9979-9
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  • #2
    has anyone tried this? or anyone involved in the study?

    Comment


    • #3
      does anyone know exactly where they inject the botox? and how long does it last for?

      Comment


      • #4
        I'm glad it seems to help.
        This is good news to me.
        21 years old
        dx: severe OAB, mild/moderate IC, depression, PTSD, agoraphobia, chronic fatigue, IBS, peripheral neuropathy

        ♥ looking for a way or medication to help stop spasms ♥

        Comment


        • #5
          i know it is helpful in OAB but how about IC??
          The two are very different although they can coincide...

          has anyone had success with botox and IC frequency. I have no leakage whatsoever! But have a problem with retention. I don't empty my bladder all of the way .. My urethra goes into spasms and will just stop the flow, in the middle of urinating.

          I am afraid to get botox for fear that it may cause me to retain more. and that is vrey painful and botox has to wear off for MONTHS!!

          It is so painful for me to catheterize myself.. because my urethra is so sensitive because it has spasms constently. and if botox made me retain , i would be in a hell of a bad way!

          Anyone have a problem like mine with their IC symptoms?

          I am not ready for Botox experimentation at all. they will have to prove it more in a group of patients that have exact symptoms that i have with the urethra spasms.. If it is ever approved for this purpose, them i may try it...

          Has anyone ever tried bladder retraining at all on any level during their treatment for IC not OAB
          Thanks
          Keep the Faith everyone!

          Comment


          • #6
            Originally posted by wolfaleena View Post
            i know it is helpful in OAB but how about IC??
            The two are very different although they can coincide...

            has anyone had success with botox and IC frequency. I have no leakage whatsoever! But have a problem with retention. I don't empty my bladder all of the way .. My urethra goes into spasms and will just stop the flow, in the middle of urinating.

            I am afraid to get botox for fear that it may cause me to retain more. and that is vrey painful and botox has to wear off for MONTHS!!

            It is so painful for me to catheterize myself.. because my urethra is so sensitive because it has spasms constently. and if botox made me retain , i would be in a hell of a bad way!

            Anyone have a problem like mine with their IC symptoms?

            I am not ready for Botox experimentation at all. they will have to prove it more in a group of patients that have exact symptoms that i have with the urethra spasms.. If it is ever approved for this purpose, them i may try it...

            Has anyone ever tried bladder retraining at all on any level during their treatment for IC not OAB
            Thanks
            Keep the Faith everyone!
            I have OAB and IC, and have no leakage at all either, and no retention. I don't think that BTX-A is used when you have retention. Either way, you should ask your Uro - they'll know what's best.
            21 years old
            dx: severe OAB, mild/moderate IC, depression, PTSD, agoraphobia, chronic fatigue, IBS, peripheral neuropathy

            ♥ looking for a way or medication to help stop spasms ♥

            Comment


            • #7
              botox

              I need to know if there is anyone who has had bladder injections with botox for IC. I've tried it for pelvic floor issues without success and now the doc wants to try botox into the bladder for pain relief. I have found very little information about it so am totally discouraged and left wondering if I try it. I already have to cath twice a day for high residuals and have frequent UTI's. The thought of having to cath all the time is a bit of a nightmare for me. The one thing I have heard about it is that most people can't void after so that doesn't give me much hope. Anyone know more about this?

              Comment


              • #8
                I have severe urinary retention.

                I was sent to a new uro (new to me), at first she didn't believe I had the retention problems, she did a urodynamics test, which showed it took me 4.5 mins to pee 300cc, and I still had over 350cc in my bladder.

                This proved the retention issues and much worse than they thought.

                Her suggestion was to give me botox in my bladder, she explianed I would need a cath steady for at lest a month afterwards.

                When I strated to ask questions about it she could not answer them, I than asked how other people she had used botox on had done, and she admitted she had never actually used it in the bladder, I would be her first, in fact she may have not used it at all I suspect.

                I said no, I was not going to be her first.

                I have since been told by 2 uros, it is not to be used for people with retention, it can make it much worse. One Uro said and I quote "I hope you ran away from her".

                I am now very glad I didn't try this, I was in pretty bad shape and desperate at the time and was close to trying anything.

                I think the use of this needs to be decided on by a case by case, depending on what you are trying to accomplish with it.

                Once it is injected in to you, you can't take it out, and it lasts a min of 3 mons.

                MG
                My are with you all. May you all find a way to peace and joy in your lives.

                Comment


                • #9
                  Bladder Expansion + Botox Injection

                  I got my bladder expanded plus Botox injections last October in a small area of my bladder. After the procedure I had to cath for 2-3 months. Its not scary its just very irritating. A couple days after my procedure I ended up in the emergency room because I could not pee on my own and my doctor did not warn me about being unable to urinate on my own. When the Botox is injected it paralyzes the bladder. The Botox did help after the 2-3 months of cathing, I wasn't urinating as much. I was on a low dose antibiotic for the 2-3 months which I got a yeast infection and had to be very careful when it came to intercourse because it could cancel out my birth control. They did have me stop taking antibiotics at one point but two days later I got a UTI. I say if you are comfortable and have the time on your hands to cath several times a day then go for it, but if your busy like me then you may want to rethink it and/or talk with your doctor. The Botox does help but it comes with complications that you will have to work with. The Botox lasted about 9 months, so the last 6 were awesome!

                  Comment


                  • #10
                    Botox?

                    I am going in a couple of weeks to see if I'm a candidate for Botox. I go to the bathroom sometimes every 10-15 min. I have not slept more than 2 hours at a time in over 5 years. Nothing has worked in the past.

                    Has anyone tried this since it was FDA approved? I've just started doing research on the procedure. Anything that you think I need to know before going for the consultation. I have to see a different doctor in the practice. One I've never seen before.

                    I'd appreciate any information I can get before my consultation.

                    Comment


                    • #11
                      SOOO happy to see others post about this. I have a new Dr. who keeps pushing me to have Botox. I repeatedly ask him about how successful it has been in other patients and he changes the subject. I'm sorry but that makes me EXTREMELY leary of trying this.

                      I have been on Elmiron and Amitriptilyne (sp?) and have been getting bi-weekly treatments of Rimso 50 (which knocks me down for the count for 1 to 3 days)

                      Lately it takes longer to urinate ... like go, wait, go, wait go

                      Finally the head nurse at the treatment clinic told me that Botox is NOT approved (here in ON, Canada) for this type of treatment so they have to "go about getting it differently) and of course I pay $660.00 for it.

                      This is my 3rd Uro Dr and I am not feeling confident in him. He doesn't believe in "pain management for extreme IC".

                      I'm about at the end of my rope. About once a month I go thru SEVERE bouts of pain and spasms. Can't eat, can't sleep, vomitting constantly, diahrea every ten minutes and losing about 10 lbs each 3 to 4 day session. I've lost 45 pounds now and really can't afford to lose anymore.

                      Comment


                      • #12
                        I was told that 10% of the patients that are treated with botox will have retention issues. I was also told that some patients would rather cath themselves 6 times a day than feel like they have to pee all the time. I am seriously considering having it done. I believe it lasts anywhere from 3 to 6 months.

                        Comment


                        • #13
                          Originally posted by GlassGirl View Post
                          SOOO happy to see others post about this. I have a new Dr. who keeps pushing me to have Botox. I repeatedly ask him about how successful it has been in other patients and he changes the subject. I'm sorry but that makes me EXTREMELY leary of trying this.

                          I have been on Elmiron and Amitriptilyne (sp?) and have been getting bi-weekly treatments of Rimso 50 (which knocks me down for the count for 1 to 3 days)

                          Lately it takes longer to urinate ... like go, wait, go, wait go

                          Finally the head nurse at the treatment clinic told me that Botox is NOT approved (here in ON, Canada) for this type of treatment so they have to "go about getting it differently) and of course I pay $660.00 for it.

                          This is my 3rd Uro Dr and I am not feeling confident in him. He doesn't believe in "pain management for extreme IC".

                          I'm about at the end of my rope. About once a month I go thru SEVERE bouts of pain and spasms. Can't eat, can't sleep, vomitting constantly, diahrea every ten minutes and losing about 10 lbs each 3 to 4 day session. I've lost 45 pounds now and really can't afford to lose anymore.
                          I'm also in ON. The last my uro told me (I'm doing Uracyst instills now) a month ago, is that he's still trying to get ahold of it. Paraphrasing what he said, but basically that he could buy it for me, and it would be expensive, but he could not inject it in a hospital. It's not approved, but could be used off-label. He's not willing to do injections outside of a hospital for safety (and I suppose legal) reasons. May I ask who your uro is? I'm seeing Dr. Stanley Flax in toronto.
                          21 years old
                          dx: severe OAB, mild/moderate IC, depression, PTSD, agoraphobia, chronic fatigue, IBS, peripheral neuropathy

                          ♥ looking for a way or medication to help stop spasms ♥

                          Comment


                          • #14
                            botox injections

                            I live in the US in Southern California and am scheduled for Botox injections into my bladder on 9/19. I've tried everything since the beginning of a flare in January, including instills medications and nerve block injections. The flare finally left but I was left with an additional diagnosis of pelvic floor disorder and pelvic floor muscle tension. The IC medication does nothing for that. My doctor believes the next course of action is the botox injections into my bladder. The FDA in the US just recently approved the use botox for bladder pain and over active bladder. I think I'm in good hands and hope to be relieved of the pain I've been in for so long. They are having good results with this at Univ. of California Irvine Medical Center where my doctor practices. I pray it works for me and that I have no bad side effects.

                            Comment


                            • #15
                              I had the botox injections and while initially I thought they helped it didn't last long at all...days maybe. My doc said some docs inject too many injections causing people to go into retention. Be sure to ask how many times your doc has done this procedure!

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