Botox has been absolutely amazing for me. I have Neurogenic Bladder from falling off a cliff. I have most of the bladder problems that a person can have (OAB, painful urges, nocturnal polyuria, very little warning, etc.).
Supposedly Neurogenic Bladder is the diagnosis that responds best to Botox. Botox decreases my daytime frequency, pain, and urgency back to my life before my fall, and cuts my nighttime awakenings and leaking (my worst problem) by 75%. Botox takes two weeks to kick in, but lasts at least three months, sometimes up to a year for some people. In the United States they often start you out at 100 units (22 needle pokes). That wasn’t enough for me so I advocated for 200 units (44 needle pokes) and received them and that is my current amount. In other countries, they often start a person at 300 units then go downward if the person had to self-cath as a result. Fortunately that has never happened to me but I could tell that if I went higher than 200, I would need to self-cath. You can have a total of 400 units in your body at one time. I get 200 units for migraines, so I couldn’t get more than 200 units in my bladder anyway.
The needle pokes are 1 inch deep. The bladder is one of the most sensitive nerve aggregations in our entire body. I recently saw mine on the TV when they were doing my Botox at a new doctor I started going to. I could not believe how many nerves there were - no wonder!
If you’re paying out-of-pocket or have a bad insurance plan, they’re very expensive. It’s at least $3,000 per injection session. Because mine are double, it’s more like $5,700 - if I haven’t get my out-of-pocket-max and/or deductible. But that can help you meet your out-of-pocket max in just one whammy. So in that respect, they’re good. Just make sure you find out how much it’s going to cost you before you get them done. Nobody told me about the price before the first time I had them done.
I have to say they are one of the most painful experiences I go through, which is really saying something after 25 surgeries and two kinds of cancers in the past seven years. They try to put some numbing gel in pre-injections but it basically does absolutely nothing (not sure if you’re make or female). Sometimes I have taken a washcloth to bite down on during the injections. If you have a partner or a spouse who can go with you to hold your hand and/or distract you, I highly recommend it. My mom came with me one time and it helped. You will be in pain for up to five days afterward and you will likely have some bleeding. The pain for five days afterward is similar to UTI pain. The Botox procedure seems to be easier for men to tolerate than for women (men have wider urethras).
Some people here report that after several years of use, Botox quit working for them, but I have not had that experience yet, thank goodness! Some people have also written that Botox didn’t help them at all.
The result is always, always, always worth it for me. I save a lot of money on diapers and bedpads and it’s just a miracle, every time! Without Botox, I barely get any sleep because I wake up every 5-60 minutes with intense and painful urgency. I don’t get a positive response from any medications. It’s such a relief to be out in public without having to instantly find a bathroom and experiencing that public humiliation of leaking or wearing puffy, ugly diapers. So, I just can’t recommend Botox enough, other than the pain.
As for a sling, most people here who I’ve seen write about them say that they haven’t worked at all and often backfire severely. If it involves any kind of mesh, I highly encourage you to read about all the lawsuits against mesh. The mesh my ex-husband for a hernia may be why he has fatal rectal cancer now.
