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    You are here : Home » Get Involved » MSRC Interactive » Help, Advice and Inspiration from people with MS » What Has Helped You » Treatments / Techniques » Botox


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    Taking the piss - a blog post by Funky Mango

    So what would make you want to have a tube shoved up your bahookie and have someone give injections to your bladder from the inside? There's some people would pay good money for that I know, but it's not really to my taste.

    Urinary Tract

    Well, it was the latest treatment for my bladder problems. For a long time now, I've had frequency (needing to go all the time) and urgency (once I need to go, I need to go NOW.) I've also had regular UTIs. Last year this reached ridiculous levels. When I stopped antibiotics for one infection, I would have about one blissful bacterium-free week, before succumbing again.

    All this was down to my detrusor muscle, the muscle that contracts when you're weeing to squeeze the wee out. I have overactive bladder as a symptom of MS, where the muscle reacts on a hair-trigger: it sends the "I'm full" signal to the brain well before that's actually the case; it responds to external stimuli like running water or opening the front door; and its contractions cause stress and urge incontinence.

    So what could be done? Well, obviously, antibiotics for the infections: I worked my way through a wide range, collecting allergies and interesting side-effects along the way (mostly hallucinations - the gazelle giving me a jar of hand cream was my favourite).

    I took part in a drug trial, self-injecting twice a week. I knew when I was on the drug rather than the placebo because I got skin reactions. It really, really helped. But then the trial ended, and I was back to the standard medication.

    The standard medication is anticholinergic drugs, which help to stop the detrusor muscle from over-reacting. They help, a little, but not much. I still have a lot of problems.


    So it was proposed that I should have botox. No, not up there. Down there. The idea is to partially paralyse the detrusor muscle so that it's not so twitchy. And the way they access it is through what's normally the exit.

    In due course, therefore, I found myself on an operating table with my legs up in stirrups, with a charming consultant in there at the business end shoving a tube with a camera attached up where only one man has been before (the urologist who did my previous cystoscopy). The equipment that let him see what was going on also had a small screen that I could see (if I wanted, which being me of course I did), and he was good enough to give me a guided tour of my own bladder - this is the top, this is where the left kidney opens into the bladder etc etc.

    The actual injections...weren't nice. But hey, I've got MS, I've experienced a lot worse. If you can imagine someone pinching a bit of your insides, FROM the inside, really hard, that's kind of what each one is like.

    But it was soon over, and there was no pain afterwards. And the very next morning, I woke up, needing the loo, yes, but not desperate - I'd forgotten what that felt like! Generally the effects have been wonderful. I can hold on for absolute hours, as opposed to my previous average of about 40 seconds!

    Predictably enough, with my history, I got an infection, but that was soon sorted out with antibiotics. I'm still on a low dose, to protect me against any more. The ongoing side-effect is that I've kind of gone the opposite way to where I was before. I now can't wee when I want to! Well, I can, but it's hard work, y'know? Seems the injections have worked a little too well. Hopefully that'll settle down in time. In the meantime it's still preferable to my previous problems.

    So all in all a positive experience, and I'd definitely recommend botox if you have overactive bladder and the standard meds aren't helping you. I'll have to have it repeated every 6-9 months, but that's small price to pay for the benefits.

    And, of course, for having the smoother, more youthful bladder I've always dreamed of...

    Funky Mango's Musings.

    Botox approved for urinary incontinence in patients with neurological conditions

    BotoxBotox (onabotulinumtoxinA) injection for individuals with urinary incontinence (bladder overactivity) resulting from spinal cord injury, multiple sclerosis and other neurologic conditions, has been approved by the FDA (Food and Drug Administration). This type of urinary incontinence is sometimes referred to as "neurogenic bladder" or "neuropathic bladder".

    People with some neurological conditions can have uninhibited urinary bladder contractions, making it harder for the bladder to store urine. Currently, patients with this conditions may be given medications to relax the bladder, while some may have to use a urinary catheter.

    When Botox is injected into the bladder, it relaxes, improving its storage capacity and reducing the risk of urinary incontinence.

    George Benson, deputy director, Division of Reproductive and Urologic Products, FDA, said:

    "Urinary incontinence associated with neurologic conditions can be difficult to manage. Botox offers another treatment option for these patients."

    The Botox is injected into the bladder using a cytoscope - a lighted instrument that goes through the urethra (tube that carries urine from the bladder to outside the body). Sometimes general anesthesia is required. The treatment is effective for about nine months.

    Before approving Botox for this treatment, the FDA looked at data on two clinical trials involving 691 participants - they all had urinary incontinence resulting from multiple sclerosis or spinal cord injury. In both studies, patients receiving Botox had significantly fewer weekly episodes of incontinence compared to those who were given placebo.

    Botox is already FDA-approved for treating facial frown lines, chronic migraine, severe underarm sweating, some types of muscle stiffness and contraction, improper alignment of the eyes, and abnormal twitch of the eyelid.

    Possible side effects may include urinary retention and urinary tract infection. Patients who develop urinary retention may have to use a catheter to empty their bladder.

    Source: Medical News Today © MediLexicon International Ltd 2004-2011 (25/08/11)

    Botox For The Bladder Is Brilliant!
    BotoxFiona Davies was diagnosed with MS in 2000. Bladder problems were one of her first symptoms.

    "Before I discovered Botox, I had tried everything for my bladder - all the drugs, intermittent self-catheterisation, the lot.I was not keen on having to wear a bag with a superpubic op. The only things left that helped were the pads you get free on the NHS.

    I also used a bladder stimulator which was helpful and a Uribag when out in the car, but at the end of the day I was peeing 30+ times a day and up to 5+ times during the night, which made my fatigue even worse.

    My bladder was really getting me down. It limited my social life as you don't feel confident if you can't get to a loo in time.

    Then, a doctor at my local hospital discussed with me the results of one of my tests. He said he's heard great things about Botox treatment. I almost laughed at him! But when I got home I decided to surf the internet for anything about Botox for bladder problems with MS and was delighted to find that this treatment looked really promising.

    I got a referral to take this further and was given a urodynamics test again under local anaesthetic so they could test my bladder whilst I was asleep, as the doctor had told me that there is no point having Botox if your bladder cannot retain enough urine. Thank goodness it could!"

    Botox has a 100% Success Rate

    I was referred to The National Hospital in Queeen's Square, London where I saw Dr Kalski. I nearly cried when he said he had treated over 100 patients with Botox with a 100% success rate!

    They are so friendly at Queen's Square and really put you at your ease and I cannot praise them or thank them enough.

    While they were doing the actual procedure they played my favourite David Gray CD, so I just chilled listening to that! I could feel some of the injections but it was over so quickly and on a scale of 1 - 10 I would say on average around 5. I was in no pain or discomfort after or the following days.

    I knew the treatment could take a while to take effect. For a friend of mine it worked in 24 hours, but it took two weeks for me, which is average.

    All I can say is that it really is a miracle and would urge anyone to have it done and not carry on suffering.

    I have to intermittently self-catheterise now as I cannot go to the toilet normally. This is common for patients who have had the treatment.

    I now sleep right through at night and can now hold for at least 15/20 minutes when I start to feel I need to go. My bladder feels calm, I no longer get the awful spasms all the time.

    My self esteem is great and I feel sexy again and definitely more confident about going out.I am also not so fatigued.I only wish this treatment had been available at the start.

    They told me the treatment lasts for an average of 11 months but can go up to two years then will gradually wear off but will never go back to how serious it was before the Botox. There is no limit to the number of times you have the treatment.

    Recently I went back to The National where they did another urodynamics test. Before I had the Botox, I could only hold around 100ml. Now it wa sup to 850ml!

    Would I have this treatment again? Without a doubt!

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