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View Full Version : botox in pelvic floor vs. in bladder



ABliske
02-12-2008, 11:46 AM
Today my uro said he knows a pain specialist who has been having good results with botox injected into the pelic floor. Has this helped any of you? My uro has injected it into people's bladders too, but says it's not as effective as when it's done in the pelvic floor.
I don't even think I have PFD. I went to a pt and she said my muscle tension was normal. How can this help me then? Please share
My main symptoms are pelvic pain, urgency, nocturia, and vaginal pain.

Sheryle
02-13-2008, 06:09 AM
I have had Botox injected to the pelvic floor, bladder and sphincters all at one time (under anesthesia). I had 26 injections in all. It seemed a little "over-kill" at first but was an answer to prayer! I had some bleeding and a bit of retention for about 24 hours but I still say "go for it!" Just remember, Botox is a poison and it temporarily paralyzes so, you might need to wear some hefty pads for a few days. I had NO control over my bladder for about 3 days and everything started getting back to normal after that. I wish you the best!

ABliske
02-13-2008, 06:13 AM
How long does the relief last? Are you still feeling good?

Sheryle
02-13-2008, 06:20 AM
I received the injections on August 24th last year and am still having some relief from them. My Doc says it last for some 12 - 15 months! Keep your fingers crossed!

wolfaleena
03-25-2008, 03:35 PM
my doc wants me to get the botox injections in pelvic floor. i have severe IC and have tried EVERYTHING i am in pain all of the time.. i take a ton of meds. the only thing that helps my pain is oxydose.
I don't think i can stand another treatment that won't work or make me worse off. It seems like everytime they do somethink internally to my pelvic floor it freaks out. I also use vaginal valium suppositores 20 mg three times a day. They help somewhat. But i have seering pain ......
I am very happy that the injections have worked for you. That is fabulous. Anyone else out there have luck with Botox injected into the pelvic floor muscles. Thanks

Mothergoose
03-26-2008, 05:40 AM
Hi I can't tell you about botox in the bladder,but I get botox in in forehead and kneck every three mos for migraines, only thing that has helpped for me. My Dr. said if I was going to try it once I needed to do it twice because it works better the secound time, and he was right. I was doing so well once that I cancelled my appointment to see if I could at least space out the injections, that was a mistake as it wore off the headaches came back. Then a mounth later I called to get an appointmnet for the shots and I had to wait another month, I can tell you it was a long two months. I can't say about the bladder, but it does work well for me for headaches. But you need to keep in mind once you get it, if it dosen't work or makes you worse you can't take it out of your body.

I would just read alot about it and ask lots of ? before doing it. With the headaches I figured they could get much worse.
Good luck best wishes Mothergoose:angel:

harleyk
04-01-2008, 11:45 AM
My urologist just mentioned this to me. Is this covered by insurance at all?

Marcia

Mothergoose
04-01-2008, 02:30 PM
I live in Canada and it is not usally cover here, unless you have extended medical and they you have to apply for it.
Mothergoose

ABliske
04-02-2008, 05:27 AM
My uro said that insurance would cover it. I don't know if you have to go through special proceedures with the insurance though.
A year ago, he said that it was still pretty new and the cost was really high - insurance wasn't likely to cover it then. So, I didn't think about it.
That's great it's working for your migraines Mothergoose! It has a lot of uses! I saw a program where it straighten out this man's neck musles. He was pretty much stuck with his head on him shoulder before that.

Mothergoose
04-02-2008, 03:56 PM
I saw the same program pretty neat.

Vicki
04-07-2008, 03:04 PM
I have had it in the pelvic floor and the bladder also. I did not find either way to be very effective. However, it may be that most of my pain comes from endo. It's just hard to say. -Vicki

cgirard
04-19-2008, 10:17 AM
Today my uro said he knows a pain specialist who has been having good results with botox injected into the pelic floor. Has this helped any of you? My uro has injected it into people's bladders too, but says it's not as effective as when it's done in the pelvic floor.
I don't even think I have PFD. I went to a pt and she said my muscle tension was normal. How can this help me then? Please share
My main symptoms are pelvic pain, urgency, nocturia, and vaginal pain.

The goal of Botox injections is to relax spastic muscles, so if you don't have tension, I'm not sure it would be of much help. However, maybe you do have PFD, and the PT missed it (this would be very likely if she didn't do an internal exam). It's probably worth getting a second opinion with another very experienced physical therapist; some of them notice things that others don't.

Overall, Botox in the pelvic floor is a pretty simple procedure, and lower risk than bladder Botox (which can send you into retention). Put it this way: I am considering a pelvic floor botox injection, even though I don't have much pelvic floor tension.

Another thing to ask your urologist is where he usually injects the Botox into the bladder -- the detrusor, the base, or the trigone. Most urologists inject the detrusor, because that's where overactive bladder patients need it. However, IC is different from OAB, and it seems that IC patients might benefit more from injection into the trigone and bladder base. For example, this is what Dr. Chris Smith does:


How many actual shots are given during a treatment? One patient reported 25 separate BOTOX injections into her bladder muscle during a treatment. That seems extreme.

(Dr. Smith) 20-30 injections. We need to spread toxin around the bladder, particularly the trigone and base of the bladder

http://www.ic-network.com/guestlectures/smith.html

Dolphjoy
04-19-2008, 11:49 AM
My pain doc and the chronic pelvic pain specialist doesn't believe in the botox yet...they say it's too new so they won't try it.

Wish you luck!

Sheryle
04-20-2008, 04:08 PM
My insurance does not pay for the Botox medicine itself, but it does pay for the hydrodistention and instill. The price my physician charged me for 3 vials was $500. total. I understand some charge much more but it is worth it. I did just have the procedure again last month so it lasted me 8 months. Hope you all get some relief soon!

cgirard
04-20-2008, 04:14 PM
My insurance does not pay for the Botox medicine itself, but it does pay for the hydrodistention and instill. The price my physician charged me for 3 vials was $500. total. I understand some charge much more but it is worth it. I did just have the procedure again last month so it lasted me 8 months. Hope you all get some relief soon!

Hi Sheryle,
Is this for an injection into the bladder or the pelvic floor?

Sheryle
04-21-2008, 02:39 AM
I had multiple injections to the bladder, pelvic floor, vagina and urethral sphincter. That's why Doc used 3 vials of Botox. Hope this helps you and you get some relief really soon. Sending hugs and prayers....

Angeles
04-23-2008, 12:53 PM
I'm glad I found this thread! I was looking for a comparison between Botox in the Pelvic Floor vs in the bladdr (or both).
My pelvic floor are very tight and I'm working on it. I know that if I have that solved my life will get muuuch better. Botox is at the botton of my list but definitely something I consider...Dr Smith is in the city I live as well as other doctors who do botox here.

My 2 main concerns with botox are:
1- the retention
2- going to general anesthesia (Do I have to?)

*Do you have to go to general anesthesia if you have botox only in the pelvic floor muscles?
* I'm not interested in having botox in the bladder. and I want to avoid general anesthesia.

cgirard
04-23-2008, 03:04 PM
*Do you have to go to general anesthesia if you have botox only in the pelvic floor muscles?


Nope. Simple in-office procedure.

Angeles
04-24-2008, 03:41 PM
Thanks cgirard! you have been very helpful in responding.
I thought you always had to be under general anesthesia to receive botox injections, in the pelvic floor, etc. I know for the ones who get it in teh bladder go under general anesthesia.

General anesthesia is definitely something I want to avoid, for many reasons, as it lowers your immunes system among many other factors. When you need it you have to ,but if it is a choice, I'll rather a procedure without it and put up with the pain.

cgirard
04-24-2008, 06:31 PM
Thanks cgirard! you have been very helpful in responding.

No problem!


I thought you always had to be under general anesthesia to receive botox injections, in the pelvic floor, etc. I know for the ones who get it in teh bladder go under general anesthesia.

Actually, even for the bladder, only some doctors put you under general anesthesia and do a hydrodistension at the same time as the Botox injection. Others will just use local anesthesia (i.e. lidocaine in the bladder); all they do is fill the bladder with some saline and then inject the bladder. If you phone around to a few urologists you might find one who does it without general anesthesia.

shawpdx1
05-22-2008, 09:20 AM
Wolfalena,
its works belive me I was on tons of pain killers nothing else worked for me voiding up to 60 times a day after botox 8-10 times a day with no urgency just new I had better go to the bathroom . only sacrafice is you hvae to self cath. but for me its a good trade off

Angeles
05-22-2008, 01:06 PM
shawpdx1: I'm glad you are better with botox...!

Did you do it on only in the pelvic floor? or in the both the bladder and the pelvic floor?


why do you have to self cath? retention?
I think you can take a medicine to avoid that, not sure the name but I can find out, some IC botox patients who get some etention take it.

sorry too many questions, but this is an option I'm "exploring"....
Take care

Grammy
06-11-2008, 02:01 PM
Can anyone who has had botox shots to the pelvic floor by the vaginal approach tell us what it felt like. Did it cause the area to feel numb like an injection at the dentist for work on your teeth, or did you just not really realize that something had been done. I have anterior pelvic/vaginal spasms and I have as yet to try the botox treatments. I am seriously thinking about giving this a try. I have had trigger point injections with marcaine and steriods and it did cause the area to feel swollen and very uncomfortable for about 24 hours. Once this wore off I got no lasting relief from the pelvic pain that I have had for fourteen years.

Dolphjoy
06-11-2008, 02:20 PM
I just got them recently. However, I was put out in twilight sedation so I didn't feel pain until afterwards. I was given 2 of morphine twice.

I went to PT yesterday and there wasn't much relief. My PT said it can take up to 12 weeks for full effect and it's variable depending on people.

Thanks
Stephanie

Vicki
06-11-2008, 02:56 PM
It was about six years ago when I had it. I don't remember any numbness. I was a little sore and tender vaginally for a few days. Otherwise, I felt the exact same afterwards as I did before I had it done. I got no response. -V

Angeles
06-12-2008, 11:49 AM
Most likely you'll be sore after the injections. Even when I read in regular magazines the side effects of botox used for cosmetic purposes, they indicate there's a possiblity of inflamation, redness etc in the area where the injections are applied. This is logical. Now...whether or not Botox will have a positive effect on you...that you'll only know if you try it. I now people that have done well on it. So you may be one who does well on it. Pick an experienced doctor, is a key, that's a key, since this is an expeimental treatment.
:) I'm interested in the subject too.....

Dolphjoy
06-12-2008, 07:19 PM
I just had my 2nd PT this week and the PT said we did so much more than before, she was able to stretch me more, and I tolerated it with little pain. In fact, I was in less pain when I left the PT, which usually does not happen for me and I am still pretty much pain free...praying this continues!

ericajones80
06-19-2008, 03:22 AM
I'm definitely going to have to look into the Botox....it sounds like it is effective to a degree for most of you

Angeles
06-22-2008, 03:35 PM
I'll go to an IC conference in September where a doctor who has a lot of experience in Botox will give a speech..I'll take tons of notes and I hope I can ask him some questions at the end.

My understanding of Botox for IC or PFD is that the sucess of the treatment may have to do with the amounts that are applied, maybe the size of the patient (?), the location of the injections and the reaction of the drug, the experience of the doctor and how advance the illness is...

I'd say to start slow, not all the way with tons of injections the first time. I wouldn't go for the bladder either at least not the first time.

I'm even thinking that it may be a good idea to apply it to another part of the body, like face wrinkles, just to see how the body reacts to it...may be a silly idea but who knows.
It is ever going to be approved by FDA for the treatment of PFD, IC and such?
The fact that is not covered by the insurance is not fun.
If anyone finds interesting articles on botox could you please share the info?

deborah bush
06-25-2008, 09:43 AM
Ido the botox with a doctor in miami he is great doctor todo the botox. i have been getting it fro about 4 years.

DEborah Bush

Angeles
06-25-2008, 02:13 PM
Deborah,
do you do botox both in the pelvic floor muscles and bladder?
do you have to go through general anesthesia?

Dolphjoy
06-25-2008, 02:21 PM
I just had a post-op follow-up with my doc. He did botox injections in my pelvic floor. He said I am doing well - he was suprised and pleased with the results so far. He examined me and was able to examine me with not as intense pain as prior.

He also said that in a couple of months, he'll decide whether or not to do botox in my bladder or instills or both. He also said that if we did instills, I'd have to be awake b/c of the frequency of them. That part scares me.

PT is going well and I'll see her next week to see if there is any more improvment.

Thanks

deborah bush
07-01-2008, 07:17 AM
Angeles I do no get it in my pelvic floor and I get it done in the office under local annes. Dolphjoy I have never heard of instille it into the bladder and I would not do it.

Deborah Bush:hi:

Dolphjoy
07-01-2008, 07:20 AM
what do you mean instill in the bladder? Are you referring to an instill of Botox? Maybe I miscommunicated...my doc said maybe he'd do botox in bladder?
Can you please clarify?

deborah bush
07-02-2008, 06:38 AM
Dolphjoy, you said "do botox in my bladder or instill or both" You have a nice day!!

Deborah Bush:cat:

justice4j
07-04-2008, 10:17 PM
Debbie,

How bad is the local anesthesia prior to botox? If it a lido gel, emulat or lido injections into the pelvic floor prior to the botox?

It's sounds pretty uncomfortable, but maybe I am making more of the discomfort than there is.

I would sure appreciate your input on this.

deborah bush
07-05-2008, 03:32 AM
Janet, they put the local anest. in the cather and into your bladder. You shift from your rt, top, and your lf side of your bode. Then he puts the flexible scope into your bladder and he puts injections into you bladder wall. It hurts a little bite when the shots goes into in your bladder wall. When its over I was oka but you may have you some burning in your bladder. I was take medecine for the burning for about 3 days after the injections. He do about 15 injecins into bladder wall.:cat:

cara1336
07-05-2008, 04:00 AM
i have had over 45 injections of botox into my bladder wall although i am not a doctor i dont think i could ever recieve botox as an instillation, it just doesnt sound safe to me. Unlike others i did not recieve relief for the botox or any instillation therepies

Angeles
07-06-2008, 02:06 PM
I think the above comment about "instillations" referred to the usual IC instillations (lidocaine, marcaine, heparin etc). I don't think it was a reference to botox instillations (that wounldn't be possible).
Many doctors do instillations as a complementary treatment to any other IC treatment the patient is receiving.
In the above case probbably the doctor wanted to combine botox injections + the usual IC instillations (lidocaine, marcaine, heparin, DMSO etc you name it) as part of a treatment, and it sounds like a good plan.
The idea behind it is to help reduce or eliminate the pain signals in teh bladder via instillations in conjunction with another treatment: because pain creates/agravates pelvic floor dysfunction in most cases.

Grammy
07-23-2008, 01:15 PM
I have two questions that I hope someone can help me with. First I do not have a verified case of IC however I have had five pelvic floor recontructive surgeries and have so many symptoms like the rest of you lovely people. I have a feeling of constant pressure. pulling, and burning in the upper vaginal floor. Has anyone had botox injections that helped them with vaginal issues. I just do not want to feel my vagina--I know that sounds strange but this burning pain is not an infection and it has been with me for 14 years. Secondly does anyone know the exact location on the tibal ankle for acupunture to be applied. If somone has a picture of it that they could scan into an e-mail or a web page with it I would be most appreciative. Guess I have one more question--has anyone found cymbalta to be a great drug for pain. I took it once and it made me extremely tired combined with pain medication. Thank you all so much . It feels so good to be a part of this group because believe me most people do NOT get it. Blessings to all of you