Interstim or Botox for OAB

[nkh18]

Because of so many recurring bladder infections, my urologist wants to send me to a specialist to see if an interstim implant or Botox would help. This last infection took awhile to clear up - trying 2 or 3 antibiotics before finding one that finally worked. I wondered if it had become antibiotic resistant. What's been your experience with this problem? Thanks for any advice you can give me.

[Seasha]

I'm sorry you had to go through this, nkh18. I haven't had any experience with bad bladder infections since I've been dx, but I do have experience with botox for OAB. Just this year I started botox injections and had my 2nd one 2 weeks ago. I didn't know that it was prescribed for infections! ??

Botox has helped me so much, especially after the 2nd one. Less leakage and frequency. It's designed to relax the bladder and for me it's still not perfect, but considerably helpful.

I don't know if this information is helpful, but hopefully someone else will chime in about antibiotics for infections.
Hope you stay clear of this issue! Take care.

[Kimba22]

Hi nkh18,

I'm sorry you've gone through this, as well. Botox can help with overactive bladder. It helps the muscles that prompt the bladder to contract relax. I don't know how that would help reduce bladder infections, though? Interstim helps with both OAB and urinary retention, so that may reduce your bladder infections if retention has anything to do with them.

I've had bad experiences from UTIs. Three turned septic. The second happened within two months of the first and went to my heart, giving me endocarditis. A few months after that ordeal, I got another bad UTI, that put me put me in the hospital. It had to treated with IV antibiotics. A few months later, I had one that went septic again. They also set off bad relapses. Each time, I was still trying to recover from the relapse before. It took more than a year before I could walk again. I wasn't resistant to antibiotics, it all just happened very quickly, before oral antibiotics could help.

Have you any tests done to determine if there’s an underlying cause for your bladder infections? Re: antibiotic drug resistance, my urologist told me antibiotics are prescribed too often when they're not needed, only contributing to the problem. Because of that, he's really cautious about prescribing them. Almost too cautious, IMO.

After testing, my urologist determined I had both urgency and retention. Retention was what allowing the environment for the bacteria grow. He put in a urethral catheter, and wanted me to get a suprapubic catheter. He didn't want any urine in my bladder, because of history. I wasn't too happy about having either type of indwelling catheter.

When I went back to my next appt, he said I could try intermittent self catherization. I did that for several years and it drastically reduced the UTIs. It also helped with urgency. Eventually I started having problems with urgency again, and asked about Botox. He wanted me to get InterStim instead, but I wasn't thrilled about the idea of another implanted device (I already have a baclofen pump, and other implanted devices that had to be replaced or removed because of infections). I also found out my insurance didn't cover it, because it's effectiveness hasn't been established for patients with neurological diseases. So I had Botox injections, and it really helped for a few years. But eventually it didn't last long as I needed it to, and could get again. So had to stop getting them.

I then self cathed more frequently. Eventually, had to move on to a suprapubic catheter, because mobility problems were making it difficult to get the bathroom. It's not perfect, but has made my life much easier.

Here's a link that includes a video that may help answer some questions: https://www.nationalmssociety.org/Sy...er-Dysfunction

An older link about someone's experience with InterStim:
https://msfocusmagazine.org/Magazine...ogenic-Bladder

This link is about antibiotic resistance:
https://www.who.int/news-room/fact-s...tic-resistance

I hope you find answers that solve this problem. Please keep us updated. Best of luck!

[KoKo]

Thank you for the links Kimba. Great info!

[nkh18]

Thanks for this information. I see a specialist in 3 weeks, so I'll be eager to hear their recommendations.

[nkh18]

Hi nkh18,

I'm sorry you've gone through this, as well. Botox can help with overactive bladder. It helps the muscles that prompt the bladder to contract relax. I don't know how that would help reduce bladder infections, though? Interstim helps with both OAB and urinary retention, so that may reduce your bladder infections if retention has anything to do with them.

I've had bad experiences from UTIs. Three turned septic. The second happened within two months of the first and went to my heart, giving me endocarditis. A few months after that ordeal, I got another bad UTI, that put me put me in the hospital. It had to treated with IV antibiotics. A few months later, I had one that went septic again. They also set off bad relapses. Each time, I was still trying to recover from the relapse before. It took more than a year before I could walk again. I wasn't resistant to antibiotics, it all just happened very quickly, before oral antibiotics could help.

Have you any tests done to determine if there’s an underlying cause for your bladder infections? Re: antibiotic drug resistance, my urologist told me antibiotics are prescribed too often when they're not needed, only contributing to the problem. Because of that, he's really cautious about prescribing them. Almost too cautious, IMO.

After testing, my urologist determined I had both urgency and retention. Retention was what allowing the environment for the bacteria grow. He put in a urethral catheter, and wanted me to get a suprapubic catheter. He didn't want any urine in my bladder, because of history. I wasn't too happy about having either type of indwelling catheter.

When I went back to my next appt, he said I could try intermittent self catherization. I did that for several years and it drastically reduced the UTIs. It also helped with urgency. Eventually I started having problems with urgency again, and asked about Botox. He wanted me to get InterStim instead, but I wasn't thrilled about the idea of another implanted device (I already have a baclofen pump, and other implanted devices that had to be replaced or removed because of infections). I also found out my insurance didn't cover it, because it's effectiveness hasn't been established for patients with neurological diseases. So I had Botox injections, and it really helped for a few years. But eventually it didn't last long as I needed it to, and could get again. So had to stop getting them.

I then self cathed more frequently. Eventually, had to move on to a suprapubic catheter, because mobility problems were making it difficult to get the bathroom. It's not perfect, but has made my life much easier.

Here's a link that includes a video that may help answer some questions: https://www.nationalmssociety.org/Sy...er-Dysfunction

An older link about someone's experience with InterStim:
https://msfocusmagazine.org/Magazine...ogenic-Bladder

This link is about antibiotic resistance:
https://www.who.int/news-room/fact-s...tic-resistance

I hope you find answers that solve this problem. Please keep us updated. Best of luck!

I've had all my testing done and they showed that my muscles are too weak to push the urine out. When I had my kidney ultrasound, it showed that I had too much retention. Because of my limited mobility ( can't transfer by myself or stand) and poor manual dexterity, she is recommending the suprapubic catheter. Kimba, can you tell me the pros and cons for you? I've watched a lot of videos about it and it seems a little extreme. Should I get a second opinion, or try PT for pelvic floor exercises? I do plan to check with my other doctors.
Any advice will be appreciated.