As much as I have written about the efficacy of Botox, I suppose I should know the answer to this question, but I don't.
Is it possible to inject Botox in the anterior (front) wall of the bladder?
I have had Botox for urge incontinence three times, and each time the Botox was injected into the posterior (rear) wall my bladder. This is typically the way my doctor performs this procedure, and is due the fact that a rigid cystoscope is used. Unlike a flexible cystoscope, a rigid cystoscope cannot be positioned easily to access the front bladder wall. To view the front bladder wall a tiny mirror is slipped over the end of the cystoscope that reflects the image and allows the front wall to be seen.
My reason for asking is due the voiding (and other) pain that I have also written about many times. I have had a couple of nerve blocks performed that have not provided much relief from this pain.
It occurred to me that perhaps the pain I feel when I empty is actually a severe bladder spasm in the front wall of my bladder, and if my doctor could inject Botox into this area, the Botox would paralyze it and this, in addition to relieving my urge incontinence, would reduce or eliminate the pain.
I brought this idea up to my doctor and, while she is reluctant to commit to it, she is going to research it. My doctor indicated the procedure is theoretically possible, but would be very difficult to do. Even with a flexible cystoscope, it would be difficult to position the needle in the correct position to inject the Botox. This might waste the Botox, which is very expensive.
As far as the treatment is concerned, the urge incontinence has priority; I can avoid the pain by not emptying completely, but I cannot control the urge incontinence if (when) it returns.
I'm going to continue researching this, but I would really like to know if there is anyone who has had direct experience!
Published On: September 12, 2008