Dr Jo Schoeman
Urological Surgeon

        

Inravesical Botox

Product Summary: AMA rates

The intravesical placement of BOTOX: PBS approved for a neurogenic bladder. Not PBS funded for non-neurogenic bladders yet.

Item Number: 36851, BM810, 105

Why is it done?

  • To alter the neuro-transmission from the Neuron to muscle receptor.
  • Refractory Over Active Bladders with Urge Incontinence.
  • Chronic Pelvic Pain?
  • Causative factors:
  • Undetermined
  • Neurogenic causes such as Multiple Sclerosis.
  • Non-neurogenic.

Pre-requirements

  • An informed consent is required from the patient.
  • Patients may not eat or drink from midnight the previous evening (not applicable if done under local anaesthetic).
  • Patients are to refrain from smoking before the procedure.
  • Patients allergic to IODINE / CHLORHEXIDINE should clearly state this at pre-admission clinics as well as to theatre staff and Dr Schoeman.
  • This is usually a day surgery procedure unless travelling from further than Brisbane.
  • Should not be on any anti-coagulation: Asprin, Plavix, Warfarin.

How is BOTOX administered

  • A General anaesthetic is administered.
  • You will be placed supine with legs in lithotomy.
  • A standard cystoscopic procedure is done.
  • 20-30 sites of 0,5 ml bleps are created in a grid fashion with sub-mucosal injections of BOTOX.
  • Usually 100-200 IU with non-neurogenic bladders and 300 IU with Neurogenic causes.
  • Dose may be individualized with subsequent treatments.
  • WARNING: You may not be able to pass urine for up to 2 weeks on your own and may require intermittent self catheterisation.

After the procedure?

  • You will be assessed to see whether you empty your bladder completely.
  • .ISC may be instituted if you cannot void or residuals are more than 300cc.

What to expect after the procedure

  • Some local discomfort may be experienced.• Your voiding nature will change within the next week to 10 days with a slow stream which may require ISC.
  • Systemic effects of BOTOX would be muscle weakness especially noticed a Paraplegic sports people.
  • After a 2 weeks period of temporary ISC, you voiding may improve.
  • Neurogenic bladder patients will still continue with ISC as before.
  • NB! Each person is unique and for this reason symptoms may vary!

What next?

  • A date will be set for a review by myself and Medtronic on regular intervals.
  • Please don’t hesitate to direct all further queries to Dr Schoeman’s rooms.

Intravesical Botox Intravesical Botox (327 KB)