Bladder Botox

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I shared this on another forum, but here's my recap of getting bladder botox today:

It was fairly uneventful as an out patient procedure. A nurse drained my bladder with a catheter and introduced some amount of lidocaine solution in. I waited ~20 minutes and the doctor came in. It was easier than the first cystoscopy I had, probably due to the copious amounts of lidocaine. I watched the monitor for the first few shots, but I started feeling the pinch and decided to close my eyes and work on my breathing. Waiting for the injections was a little nerve-wracking.

The actual procedure with 20 shots was fairly quick. I voided immediately after getting dressed. The worst part after the cystoscopy (and subsequent voids) is the pinch/pain feeling urinating. That was worse afterwards than the injections.

Anyway, my doctor says I should give it a week or so before I see any kind of relief. I have a two week followup to check for retention, but I'm instructed to let her know if I feel like I can't go beforehand. Not sure I expected this, but she did say that my stream would probably be slower after it kicks in.

Last note, and this is a funny one, but after some air gets in the bladder it makes a funny noise coming out. It reminds me of a water hose expelling air.

 

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Sounds scary to me

 

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I had the same procedure in July 2022. The feeling of the scope gong up the “man pipe” was weird, and a little uncomfortable in the sense of not feeling natural. The lidocaine certainly helped, as I felt only a little pinching. Voiding afterward was fiery, but also with the air escaping.

My doctor told me that it would take about 60 days for the Botox to reach maximum effect, and last up to 9 months. That was almost exactly my experience. As my flow rate increased, I made the decision to implant the AUS, which has been like a miracle device.

 

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I have so far rejected taking botox shots due to the risk of urine retention resulting in prolonged catheterization. I can't deal with a catheter for more than a day or two and the possibility of it going beyond that scares me. Also, since the botox only lasts 6-9 months, the risk of retention is there again every time shots are taken. I read a study a couple of years ago in which about 10% of the people in the study who had the botox injections experienced retention - anywhere from 24 hours to several months.

 

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@Walter I hear it's possible. I'll update on my situation so you at least have another data point.

 

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After years of dealing with urgency and frequency, four Interstim implants the last one finally started working after it had been implanted for eight months. Before it started to work I made an appointment for Botox injections. I was happy with how it went. My urologist had me inhale nitrous oxide during the process using an FDA-approved product named PRO-NOX. "PRO-NOX uses a 50/50 combination of oxygen and nitrous oxide that is inhaled to provide fast-acting pain relief that increases comfort and aids in calming anxiety. PRO-NOX is not general anesthesia and will not put you to sleep."

Medicare does not pay for it and it costs $150. Before the PRO-NOX got into my system the first two injections were very uncomfortable. The injection process took about 7 minutes.

It sure is working. I don't know if my situation would have been "fixed" with just the Interstim, but Botox definitely has been effective.

@snow suggested this and she was right about its effectiveness. Thank you.

 

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@Walter I'm a week out, and I'm definitely seeing some differences. I do feel improvements with my general sensitivity (Urodynamics noted I start feeling pressure at ~30ml). I'm not noticing as many urges, but I am seeing a restricted urine flow. My urologist did warn me about it, but I'm wondering if it's too slow, as I'm seeing myself strain to get it out. I have an appointment next week to see if there's any retention.

 

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Thanks for the update

 

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@lorumipsum I hope it goes well for you. The effects are not fully realized until a month out. Might consider asking your doctor for a dozen or so catheters if they haven't already gave them to you, just in case.

Lastly, If you haven't done so already, a search will find multiple discussions that may help lend perspectives/accounts.