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I have a question listed below.

By August 1, 2017 - 11:03am
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I had bladder sling surgery last month and leak worse now than ever. I'm told this may be a different type of OAB. Should my next step be the Botox or the pacemaker?

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HERWriter Guide

Hello parjmar1

Thank you for writing.

This is something you need to discuss with your doctor or surgeon.

InterStim bladder neuromodulation can be tried if your surgery didn't work but your doctor can explain the criteria needed to be approved for this process. InterStim is a bladder pacemaker-like device that can reduce the symptoms of overactive bladder (OAB) in about 75 percent of patients when medications for OAB fails or cannot be tolerated. There has been some secondary gain in several small trials, showing reduced bladder pain with the use of InterStim when implanted for OAB.

BOTOX® injections in the bladder muscle via cystocopy can relax the bladder, making for greater storage capacity and decreasing the frequency of urinary incontinence. Cystoscopy makes it possible for a doctor to see the inside of the bladder during the injection.

Two clinical trials of 1105 patients with OAB have established the safety and efficacy of BOTOX® when it was administered randomly to patients in injections of 100 units of Botox (20 injections of 5 units each) or placebo.

After 12 weeks, patients who received BOTOX® experienced an average of 1.6 to 1.9 times less urinary incontinence per day and needed to urinate 1.0 to 1.7 times less often throughout the day. Their output of urine was 30 mL on average more than the placebo group.

Treatments should be at least 12 weeks apart.

There were side effects to the treatments, such as urinary retention, incomplete emptying of the bladder, pain upon urination and urinary tract infections.

Urinary retention, or incomplete emptying of the bladder, may require catheterization to resolve.

We cannot suggest which treatment is best for you but I hope the above information has helped.

August 1, 2017 - 12:41pm
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Overactive Bladder

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