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Suggest treatment for urinary incontinence

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Posted on Tue, 30 Dec 2014
Question: I have tried every drug available for bladder incontinence as well as a electronic stimulus device. I'm curious if the new botox treatment is to be considered? I am afraid of the many side effects I've seen on tv and in reading. Am I stuck wearing pads and depend panties? Please help. Thank you.
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
I recommend it but should have realistic expectations.

Detailed Answer:
Hello. I read your query and I am sorry about what you are going through and the disappointing results of the treatments tried up to now.

The botox treatment is becoming very popular and widespread for the treatment of bladder incontinence from overactive bladder. So naturally this is a valid option presented by your doctor and you should consider it. After all, you say you have already exhausted the other options whether drugs or electronic stimulus device. The side effects like infection are not that frequent especially with antibiotic prophylaxis and painful urination is temporary, other complications are extremely rare.

There is also the possibility of retention which is estimated to be present in up to 25% of cases, a catheter might be needed but since the botox effect is not permanent it will wear off eventually, if you regret it you'll simply not repeat it.

So I think when it comes to side effects the risks are acceptable and I would recommend it.

What I want you to consider though before taking a decision are your expectations. I see that you ask whether you're stuck wearing pads, so being completely free of symptoms is a priority to you when deciding for this treatment. What I want you to be conscious of, is that this treatment rarely resolves the symptoms completely, the goal is only to reduce them (by an average of 50%), rarely do we achieve resolution. Also the treatment will wear off and will have to be repeated every 3-9 months.

So you should weigh a 50% only expected benefit, towards the risk of temporary retention (up to 20%) and the need for repeat of procedure

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Olsi Taka (2 hours later)
Dr. Taka,
Thank you for your quick reply and advise. I was not advised that the Botox was a temporary fix and following your info, I will give it a trial. I did see on utube the procedure with the catheter and do not find it appealing! However, the percentages are in my favor. I was never told that a complete cure was possible, so the Botox is probably my best option at this time. Thank you for educating me on the pros and cons of Botox.
doctor
Answered by Dr. Olsi Taka (4 hours later)
Brief Answer:
Good luck

Detailed Answer:
I am pleased you have found my answer helpful. I hope things work out for the best.
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3674 Questions

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Suggest treatment for urinary incontinence

Brief Answer: I recommend it but should have realistic expectations. Detailed Answer: Hello. I read your query and I am sorry about what you are going through and the disappointing results of the treatments tried up to now. The botox treatment is becoming very popular and widespread for the treatment of bladder incontinence from overactive bladder. So naturally this is a valid option presented by your doctor and you should consider it. After all, you say you have already exhausted the other options whether drugs or electronic stimulus device. The side effects like infection are not that frequent especially with antibiotic prophylaxis and painful urination is temporary, other complications are extremely rare. There is also the possibility of retention which is estimated to be present in up to 25% of cases, a catheter might be needed but since the botox effect is not permanent it will wear off eventually, if you regret it you'll simply not repeat it. So I think when it comes to side effects the risks are acceptable and I would recommend it. What I want you to consider though before taking a decision are your expectations. I see that you ask whether you're stuck wearing pads, so being completely free of symptoms is a priority to you when deciding for this treatment. What I want you to be conscious of, is that this treatment rarely resolves the symptoms completely, the goal is only to reduce them (by an average of 50%), rarely do we achieve resolution. Also the treatment will wear off and will have to be repeated every 3-9 months. So you should weigh a 50% only expected benefit, towards the risk of temporary retention (up to 20%) and the need for repeat of procedure I remain at your disposal for further questions.