Botox for overactive bladder/nocturia/frequency/urgency

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My bladder wakes me up frequently at night and I am making 5-7 trips to the bathroom. During the day I can last about 1.5 hours before seeking a bathroom. I had a PAE with minor success, but now my IPSS score is back to around 30. My urologist is suggesting Botox injections into the bladder to control this. He doesn't think a TURP will help me. Has anyone here had this Botox injection procedure and if so, does it work? Side effects?

Thanks, Tom

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  • Posted

    Tom:

    Have you tried wearing compression socks during the daytime. They work pretty well for me. They reduce swelling in the lower legs; otherwise the kidneys process that fluid at night. They cause you to urinate more during the daytime, but less volume at night. I get up twice a night and usually sleep 3.5 to 4 hours before the first time (used to be 2 to 3 hours). I measure my urination output and when I don't wear the compression socks, the urine output at night is typically 30 to 40% more than when I do wear the compression socks. I wear the compression socks during the daytime not while sleeping.

    The odd thing is I am 6 feet tall and 185 pounds. No one looking at me would think that I have swelling in my lower legs. Even my uro didn't think they would help much. Might be worth a try as there is nothing to lose and I believe no risk (although I am not a doctor).

    I am assuming you are already limiting liquid intake after the early evening (of course, alcohol can be a major factor as well). If not, this might be the major cause of your problem.

    Good luck.

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    • Posted

      Rdemyan,

      This is the first time I have heard about compression socks making a difference in the amount of urine processed. It sounds interesting, I might try it out, because I produce a lot more urine at night, and have to cathterize more often at night, which is inconvenient.

      Thomas

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    • Posted

      It does have to do with the bladder because the bladder stores and expels urine produced by the kidneys. If fluid is being "stored" in your lower legs during the daytime, the kidneys process that fluid during the nighttime when you sleep. That leads to more urine which is stored in the bladder. The bladder fills and has to expel. Google "compression socks for nocturia" for more information.

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    • Posted

      Thomas:

      I don't have to self-cath, but I recently have had a few events where I had great difficulty peeing at night. One night, while sick with a UTI, I couldn't urinate and tried to make it to the emergency room. However, the UTI was causing extreme bladder spasming that lead to uncontrollable defecation when I would release my pelvic floor to allow what little urine would come out. The next day I learned to self cath for emergency situations only.

      As I thought about my situation, it seemed to me that if I had less liquid in my bladder during one of these emergency situations, that would give me more time to make decisions. The compression socks seem to do that for me. When I wear them, I seldom pee more than 300 mL during a night time trip. Without them I generally urinate more than 300 and recently peed 450 mL, which for me was an incredibably high amount (however, I see it as a good sign that my bladder can still stretch and hasn't become too hardened yet - at least I hope I am interpreting it correctly).

      Note though, that while you might urinate less liquid, the amount of times you get up might not change that much. After several months now, I am consistently at 2 times per night (very occassionally one time and very occassionally 3 times). Before I was pretty consistently at 3 times. But for Tom, who is getting up 5 to 7 times a night, maybe it will make a significant difference.

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    • Posted

      He seemed to indicate that it wasn't much of a problem during the daytime. Still, he can look at my suggestions, your suggestions and the suggestions of others, and decide what he wants to do. Like you I am just giving him some suggestions.

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    • Posted

      Rdemyan,

      I saw a Urologist last summer who said that we urinate more at night because gravity pulls liquids down during the day, but at night while you are laying flat the kidneys can process that liquid. I have noticed that my urine at night is very clear, maybe because it is not coming from food or drink, but from the body's tissues. I also have vericose veins and restless legs which according to some people go along with the edema ( swelling of the legs with water) and nocturia theory. I will look more into it.

      Thanks for the post

      Thomas

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    • Posted

      Thomas: Yes, that's it exactly. Do you measure how much you urinate when you go? If you do, it would be great if you can provide some quantitative results pre-compression sock and post.

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    • Posted

      rdemyan,

      Actually, the urge to go to the bathroom occurs during the day as well, but it is less of an issue because I am not trying to sleep and I can always find a bathroom.

      Tom

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  • Posted

    Hi Tom,

    I have had the same problem and was prescribed a drug called Tamsulosin which relaxes the bladder and urinary track so that you can pee easier.

    However, I suspect you are not in the UK. Could you explain what the PAE is and also IPSS? Just checking if you have had the same treatment that has shrunk the Prostate. I will pass on my experience.

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    • Posted

      Tamsulosin is being widely used for this problem. It had been suggested to me also during my several visits to the urologists but it has not suited me. It further lowers my already low BP. Anyway I avoid taking water in the evening thus reducing my visits (3) to washroom at night. I will also try compression socks.

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    • Posted

      Hi iqbal:

      An alternative to Tamsulosin is alfuzosin (Uroxatral). Alfuzosin is a newer drug, and it is supposedly a somewhat more specific alpha blocker than tamsulosin. It works better for me with less sexual side effects and according to a study done at the University of California San Francisco, it has less potential to cause floppy iris syndrome (which can be a problem during cataract surgery). Alfuzosin is prescribed more in Europe and outside the US than in the US (but it is available in the US). In fact, I had to educate my uro about it. He was aware of it but had never prescribed it. He recently told me that he and his department head had a discussion about starting to prescribe it more.

      I have low blood pressure as well. Occassionally with alfuzosin I will feel just a slight disorientation especially when standing up. However, it is significantly less than what I experienced when I was taking tamsulosin.

      Rapaflow might be another alpha blocker to consider, but I have no experience with it.

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    • Posted

      I have less side effects with flomax. Everybody will have different results. flomax was approved by the FDA in 2010 , Uroxatrol in 2003. I think Flomax is the newer drug.

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    • Posted

      Hi trustme:

      No. The FDA approved generics of Flomax in March of 2010. Flomax was first marketed in 1996 and granted approval by the US FDA in 1997. Just google "flowmax fda approval date."

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