Will Botox treat a weak detrusor muscle and an overactive bladder?

Question

Hello doctor,

I have been told that I have a weak detrusor muscle and an overactive bladder. I feel constant irritation in the bladder and sometimes, my lower abdomen area swells up. I had negative urine cultures, and I have been told Botox may help me, but I can only have 50 percent or so strength due to the weak detrusor. Can you confirm that Botox and bladder hydrodistention will eliminate constant irritation feeling? Also, can the detrusor ever recover?

Answer 1

Hello,

Welcome to icliniq.com.

Botox is used for overactive bladder, once oral anticholinergic medication fails to give benefit. Botox gives benefit for 6 to 9 months, so it has to be repeated after a year. There is a risk of detrusor acontractility after injection, for which you might have to use CIC (clean intermittent catheterization). Detrusor gets recovered with time. Hydrodistension may be beneficial for the constant irritation feeling which you used to have. This is mainly used for interstitial cystitis (IC).

Answer 2

Hello,

Welcome back to icliniq.com.

Theoretically, it is possible but practically, I have never seen detrusor strength recovering 100 percent. In fact, overactivity starts after six months and by nine months to a year, same baseline activity is seen. But initially after injection, it is possible that you might have to use CIC but strength will return. Do not go for hydrodistension in the same sitting. First just get Botox injection then evaluate the results.