Hydrodistention for OAB?

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Anyone tried this for OAB? I know it is used for Interstital Cystitis. But that is not my diagnosis. My urologist suggested it as I have had no Luck with meds, PTNS, Botox, or Interstim. He said It has some anecdotal evidence for use in OAB. I am inclined to try it since I’ve run out of options, and other than being given general anaethesia, and filling the bladder, it is not that invasive - certainly much less than two Interstim surgeries.

 

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Hi thanks for the post. I haven’t heard of this yet but if your urologist suggests it may be worth a try. Please let us know if it works.

 

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It sounds like you've thoroughly tried other proceedures.
What are the risks here?
Is it potentially going to make a less controlled bladder if it doesnt work? Would be my concern.

 

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I’ve tried it, without general anesthesia. I had a local that didn’t help at all. The procedure didn’t help at all. I’m a female. It may be different for you. Women have to spread their legs lower and wider than any OB-GYN procédure, including cancer removal. It’s humiliating. It’s the most embarrassing procedure I’ve ever had, and I’ve been through A LOT: seven separate OB-GYN surgeries. They hurt, but they happen in a less vulnerable position. HOWEVER. I do think you should try the procedure in case it may help you. I’m glad I tried it, despite the pain and humiliation, and even though it didn’t help. You have to try everything. It just might help. You’re so lucky if your doctor will knock you out for it; I wish mine had.

 

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Maybe they have to do more anesthesia on males because of male anatomy. I always think it would be so much more painful to be a guy having bladder procedures, than to be a female. Women have a much shorter urethra and it’s more easily accessed (nevermind the leg spreading, but we females start getting used to that humiliation in our teens).

 

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I would think bladder procedures are uncomfortable and painful - period! Whether you're male or female. I wouldn't voluntarily have something like that done to me unless my doctor absolutely says I must have it done. I don't take medical procedures like that lightly but if nothing else has worked then by all means have it done and make sure your absolutely trust the doctor and know his credentials before submitting to anything that involves general anesthesia.

 

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I have it done while I’m out and having more Botox injections. Nothing seems to help with OAB.

 

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I mean urodynamics entail filling your bladder in a similar way so I don't see what major risks there would be. seems worth a try. just uncomfortable and embarrassing.

If you've had all the regular battery of uro tests done this shouldn't be any more humiliating than all the rest.

seems like a no brainer to try it....though after all of the tests and treatments I have tried, I'm donezo..I'll wear diapers and accept it. But if you're willing to keep trying then go for it.

 

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The thought is that I will be relaxed under anesthesia, and my bladder possibly can be pushed to hold more. I have never had a recent void that is anywhere near typical capacity.

It makes some sense to me because I generally don’t wake up firm spasms, and some of the largest voids are first thing in the AM. And even before he suggested up it, I wondered if my bladder could be stretched while unconscious.

 

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Kathylp, you mean you get general anesthesia for these procedures? That option has never been offered to me!!!!! Maybe I need to change doctors!!!!!!!!!!

Bobsledd, and other males, I’m curious if you don’t mind, for urodynamics, what position do they put you in? Is it spread-eagled like for women? I don’t see why it would be. Seems to me you could keep your legs closed with your penis out. If not, if you have to spread your legs just for pee stuff, without having grown up with OB-GYN stuff, I can imagine how traumatic that might be to encounter suddenly, middle-age.

 

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I’m not trying to be gross, just trying to understand the difference between male and female procedures.

 

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I think I may need to try a different doctor.

 

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@snow for ordinary urodynamics I have just been lying down with a paper towel over me with a hole for access. The worst was video urodynamics, me completely naked with catheters front and back and 4 females for company. At the end they asked me to pee in front of everyone and the x-ray camera. My sphincter clamped tight and nothing was going to come out! Hideous! Cheers Phil

 

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Thanks for educating me, physlink. I didn’t have a choice about peeing; they told me I peed more than anyone ever had, and my urologist is 73 years old. I peed through all the pads and made a huge mess on the floor, which surely was not my choice. Wellllllllll, even though the male procedure sounds a bit less awkward than the female spread-eagle, I still feel bad for you guys because any tube has to travel farther for you.

 

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Hi Snow, definitely do try a different doctor. And that's especially if you've just consulted with only one doctor. Anyone who has been told by one doctor they need to have any type of invasive procedure or surgery done should always (unless it's a huge emergency) get a second opinion! The next doctor you see may have a better idea and a plan that is less invasive or at least gives less discomfort. If your doctor is "the only game in town," try to contact the urology department at a nearby university or medical center for names of boar-certified specialists. You may need to spend more on bus fare, but it might be worth it. So please get a second opinion!

 

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Hi Snow again, my post just now should read "board-certified," not "boar-certified." I don't think urologists do much work with wild pigs!!!! And yes, my typing can be atrocious at times. But it really hasn't affected my quality of life all that much!!!!

 

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When they did mine it was in a standard uro exam chair the big whit ones with places for your feet and a cut out for the pelvic area. It is weird trying to pee past the catheters after the filled me up. Good luck trying to hit the cute and container it soaked the pads on the floor and I’m pretty sure they expected it. They use very thin catheters one for pressure test in urethra and anus and on for liquid in urethra to measure output and volume. You can really feel them they are so small. (Didn’t want folks to get scared). The flexible cystoscope didn’t hurt much but I could feel some pressure going past the prostate curve. Was neat to see inside of the bladder and watch the uterers contracting as urine was filling the bladder from kidneys.
The lady techs didn’t bother me in the least and they did a wonderful job.
The next visit who they did the Botox injections the loaded my urethra with lidocaine gel for about 10 minutes. Trying to use a straight cystoscope hurt going past the prostate curve even with lidocaine gel.
Need to get more shots since these have worn off now but still trying to decide if I want the doc to knock me out this time while it he injects the Botox. Snow nailed it in one of her posts, barbaric was a good word choice. Was certainly a learning experience.
I didn’t really have any embarrassment but it was interesting trying to walk normally for an hour after they stuffed the straight metal cystoscope in me.

Oh, something important about Botox injections. If you have an FSA for your medical expenses. Bank of America rejected my receipts and I am still trying to get my 500 copay money back and my account unlocked. You have to take a form from your FSA webpage for Medical Necessity and have the doctor fill it out and send in your explanation of benefits from your insurance to get it covered. It’s deems it primarily cosmetic (even though it’s a urologist instilling shots in your bladder). I don’t want others getting screwed by them like I am being. It’s already heard enough dealing with urinary issues than to have to deal with loosing your own paycheck deductions fighting with you FSA administrators. Very disappointed in how this has been handled for the last 3 months and I am still getting emails to pay back my $500 to my FSA account despite several attempts to get my urologist to fill out the form after I found out it was needed.

 

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What really bites is they want me to payback my own money that I put into the account and it’s a legit procedure. Not to mention the froze my account so I can’t pay for the rest of my expenses with my FSA until it’s resolved. Bunch of crooks

 

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Jrpoorman, I’ve been through (am now going through) similar financial / insurance crap. My deductible is one of my biggest concerns in life, primarily for bladder Botox (Bleck!!!!!). I agree: it’s so insulting after all the pain and dilemmas of having urinary problems, to have to additionally deal with insurance / financial crap. I also agree that bladder Botox is the opposite of “cosmetic” Botox, which I had for my wedding 10 years ago (he left when I fell off the cliff and started having bladder/pelvic issues). Bladder Botix is totally NOT cosmetic!!!!!!!!!!

 

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Also: yes, bladder Botox is excruciating. 100cc = 22 shots, 200cc = 44 shots. You’ll feel every shot. I hate being awake for it. Totally worth it in the end, but dang it hurts while it’s happening (10-15 minutes). I wish I had someone’s hand to hold, though I might break it! I take a washcloth to bite down on. I’d love to cuss about all of this, but I don’t know if it’s allowed here on these boards, so I refrain. I totally agree that the straight metal catheter hurts the most. My doctor has a bad habit of putting in the anesthetic only a mere few minutes before procedures. I think he does that because the gel doesn’t really work. He’s told me that while the bladder has more nerves relative to any other organ, those nerves pretty much can’t be quieted. Sucks. But here we all are, surviving. Before diapers, people just sat on newspaper. Could be worse.