Botox for Temporary Incontinence?

[BaronBrook]

I'm looking into "try before you buy" options for urinary incontinence & have seen people bring up botox as a 3 to 6 month incontinence possibility.

It seems to be a misunderstanding? 

Procedures that use Botox are about treating urge incontinence & providing more control.

From the mayo clinic:

A urologist can inject Botox into your bladder to treat urge incontinence or overactive bladder. This helps the muscles relax, which will give you more time to get to the bathroom when you feel the need to urinate.

Does anyone have experience with this or with any other approaches to trying incontinence? 

I've been thinking about delay release diuretics, but those are apparently very bad for you.

[BrownBobby]

So...this is a fundamental understanding of which procedure is being talked about.  All of that is valid...if you're injecting it into the bladder.  However, if you were to instead target the external urethral sphincter (the voluntary muscle used in urinating), the muscles relax and can't close properly, making it much harder to hold back when your subconsciously-controlled internal sphincter decides to release.  

Now, the rub.  Urologists will be hesitant to offer this option, especially without medical cause.  This doesn't mean you CAN'T have it happen--it's just much more involved than showing up and asking.  I've gotten a urologist to help me with options like this, but it's taken 18 months of trying a lot of other things, combined with therapy with two counselors to make sure I was of sound mind to request it to begin with.

As for delay release diuretics...I can't recommend AGAINST them highly enough.  The ER visit after trying them is what finally got me to find that urologist in the first place.

[BaronBrook]

It's really good to know that about diuretics! You may've saved me a hospital trip!

I've been working with a counselor for 3 years & the end of this month is my first referral to a urologist. May also be getting a referral regarding mental health meds, but we're not sure what.

My hope is to put together an honest & well thought out pitch with a few ideas to work toward. I'm excited, but I expect to run into many hurdles.

[BrownBobby]

If that's where you are, then you're in an excellent place to move forward.  Feel free to PM me if you want--I can tell you what I did to find and convince a urologist, and maybe answer any questions you might have. 

[BaronBrook]

Thank you! Message sent!

[Steve_bhuk]

I have had Botox injections to my external urinary sphinicter in the past and would be happy to share my experience with you.

[tspotters]

I am curious to know what is it like.  How much control do you have?  Does the control change over the 3-6 months?  

[Steve_bhuk]

I have had Botox injections into my external urinary sphinicter three times using 100, 200, and finally 300 units. These treatments were done under general anaesthesia about 6 months apart, with the last one being in mid 2013.

 The first two treatments were not very successful, and I still had pretty much full control, although I think there was some wetting whilst I slept. The third treatment was more successful, but did not result in full urinary incontinence.

I had that last treatment 2, or 3, days before going to a Star Wars Celebration in Germany, followed by a 3 week railway tour around Germany, a visit to Paris and Disneyland Europe, returning home to the UK. It felt incredably freeing to know that I was going to be somewhat dependent on nappies for the whole trip.

I could still clench my external urinary sphinicter, and hold it for a few seconds before it relaxed. Using this technique I was able to go about 2 hours from first feeling some pressure in my bladder to not being able to stop it from starting to empty. I would have to equate my bladder control during the trip to that of a toddler. If I went to the potty when I felt the need I would not have an 'accident', but if I didn't, and also whilst I slept, I would end up wetting my nappy.

I would love to have this done again using 400 units of Botox to see if it would give even more relaxation of the external sphinicter, and result in a total inability to clench the sphinicter.

[rick50]

Hi Steve, can you say how you got the botox therapy, was the doctor aware why you wanted it? How difficult was it to be treated? Are you classsed as incontinent now and is your loss of urine in a drip or does it build up and then flood your nappy?

[nappylover78]

On 2/2/2021 at 7:53 PM, Steve_bhuk said:

I could still clench my external urinary sphinicter, and hold it for a few seconds before it relaxed. Using this technique I was able to go about 2 hours from first feeling some pressure in my bladder to not being able to stop it from starting to empty. I would have to equate my bladder control during the trip to that of a toddler. If I went to the potty when I felt the need I would not have an 'accident', but if I didn't, and also whilst I slept, I would end up wetting my nappy.

Sounds like quite a nice level of incontinence to have. I wish there was a way to just experience it for a day or so!

[Steve_bhuk]

On 2/5/2021 at 9:13 AM, rick50 said:

Hi Steve, can you say how you got the botox therapy, was the doctor aware why you wanted it? How difficult was it to be treated? Are you classsed as incontinent now and is your loss of urine in a drip or does it build up and then flood your nappy?

Mmmm. Long story or short answer, that is the question??

I have had the desire to experience incontinence since I was about 11-12, but it was only after I got private medical insurance through my job much later in life that I was able to make any progress towards getting professional help.

I started by seeing a Harley Street psychiatrist who was very supportive, and not only wrote to my GP, but also referred me to a Urolologist friend of his. Although his friend was not able to help, he in turn referred me to another Urolologist. It was this doctor who after 2-3 years of discussions eventually agreed to do the first Botox injection as a supplement to a bladder neck incision that I needed to cure some genuine urological problems that I had at the time. He also did the other two Botox injections without hesitation when I requested them.

As I said previously the closest I got to being incontinent, was after the third try, when I had the bladder control of a potty training toddler, and would eventually end up wetting my nappy; not quite a flood, but a good stream.

I was upfront and completely honest with the psychiatrist, both urologists, and my GP about what, and why, I wanted as this was the only way that I could see to achieve what has been an almost lifelong desire.

Unfortunately Botox is not a long-term solution, as the effects only last for between 3-6 months, depending on which muscles it is injected into. The stronger the muscle, the quicker the effects will wear off.  So, no I am not currently classed as incontinent.

On 2/5/2021 at 5:10 PM, nappylover78 said:

Sounds like quite a nice level of incontinence to have. I wish there was a way to just experience it for a day or so!

If you could get a Urolologist to inject the external sphinicter with a long acting local anesthetic, you should get the 'benefit'? of the effects for about 6-12 hours.