Botox and the Bladder

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I have had 2 Urolift procedures and even though the second one fixed the problem that the first doctor avoided, I still get up a lot to pee. My Urologist said that the prostate is OK but from many years of forcing the urine out, my bladder has stiffened. He recommends Botox to relax the bladder. Has anyone had any experience with this procedure? I'm 87 and outside of this I'm pretty healthy. Thanks, Albin

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  • Posted

    Two procedures?  Hmmm... Albin, my experience may be of interest, ltho' I'm 21 years behind you.  I had YEARS of prostate-restricted flow, unknown and unaddressed.  When my pee-flow shut down completely (Aug 2014), they drained off 2.5 liters (yes, 2.5 liters) of fluid.  My bladder now, rather than being "stiff," is distended.  The box-like muscles (as opposed to the sinewy muscles of the arms and legs) lose their ability to return to their original configurations.  In my case, the bladder never fully drains on its own, even though my life has otherwise returned to "normal operation," post-op (Two months ago; great surgeon, the most experienced one in the US).   Accordingly, I have adopted night-time cathing.  For me, intermitant cathing became second nature for 15 months, until I found and could arrange the surgery, 2,000 miles/3,000 km from where I live.  So for me to do it every night is no big deal, and far less than the every-time use I experienced over 2,000 times.  The bladder drains fully, and I sleep through the night, almost every single night.  Does that sound better than what you have?

    I would encourage you to do some Googling on your surgeon's Botox idea, and please share any info you find!  Curious minds want to know!  :-)

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  • Posted

    I would certainly get a second opinion from someone who knows what they're doing before I did that. It may be exactly the right thing to do but it is certainly extreme.

    Neal

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  • Posted

    If the problem is incomplete emptying, then you might do some research on Botox, as suggested. Another alternative as mentioned is clean intermittent catherization (CIC).

    On the other hand, if your night time problem is being caused by an over production of urine at night (nocturia polyuria) then neither botox nor CIC is likely to help much.

    For example, I sometimes produce over 1000ml of urine between bedtime and morning, so even if I empty completely, I will still have to get up at least twice a night since my bladder signals to empty at around 3-400ml. It's simple math.

    So if you and your doctor haven't already done it, you really need to do a urine output/fluid input log in addition to the the standard voiding tests, and determine what exactly is causing you to get up at night.

    I hate to state the obvious (above) but all too often docs skip these steps and right away offer their go-to treatment, be it a surgical procedure or in your case a botox injection.

    Jim

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    • Posted

      Thanks, Jim, as well as the other men that have that suggested solutions. I did consider CIC but I see that so many men seem to get infections from this. Have you been able to avoid infections and if so, how? Also, there is such a choice of catheters that it becomes confusing. My Urologist said that I retain 250ml. after voiding. I must admit that it would be nice to sleep through the night again. That hasn't happened in over 20 years. The only good news is that I go back to sleep immediately after getting up to pee. 

      Thanks, Albin

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    • Posted

      Infections through CIC yes, been there, done that.  Avoidable (perhaps) by being OBSESSIVE about cleaning protocol.  Not my expereince though.  Three times over the 15 months where I had to cath EVERY TIME I wanted to pee (4 or 5X per day).  One avoidable contamination time: forgot to drain before bed, did in middle of the night, forgot to use alcohol to prep!!!   Wound up with epiditimis within hours.  FOrtunately, antibiotics knock out those UTIs predictably.    SInce I "cleaned up" my prep protocol, a few months back, I have had no problems.                I HIGHLY recommend SPEEDICATH: pre-lubed, silicon.  RUBBER caths?  NFW!  Urologist assitant used one on me during a visit for testing, and I was sore for two weeks!   

      The main thing is to find a cath that works for you, figure how you can carry them (The Speedicaths are straight, in foli packs, but can be carefully rolled for pocket carrying.  Carry alcohol individual packs.  That sort of thing.

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