The introduction of bladder Botox injections (FDA approved in 2008) to the treatment arsenal has dramatically changed the bladder symptom care for women with neurological conditions. They may also be affected by conditions common to all women such as prolapse, pelvic floor dysfunction and stress incontinence.
We have noticed that important issues such as sexual and bowel function are often not considered in the treatment plan, and women may be started on medications with no consideration of conservative treatments.
We believe it is of utmost importance that women who have neurogenic bladders be seen by specialists who also have the ability to treat urogynecological conditions (i.e. “female problems”) that may affect them as well.
We will always remember that you have a neurological condition affecting your bladder, but we will always offer treatment options traditionally used in women for non-neurogenic conditions.
You'll start with a thorough intake evaluation that includes a detailed urinary history and a physical exam.
Due to the complex nature of neurogenic bladder, more information may be needed to devise a treatment plan tailored to your particular symptoms.
At a minimum we will test the urine for infection and obtain a renal ultrasound.
In many cases we may recommend cystoscopy (a test to look at the appearance of the bladder) and urodynamics (a test that helps to demonstrate how the bladder is physically functioning).
While we will suggest a treatment plan, the final choice is up to you.
We are very aware that many women with neurogenic bladder conditions have had negative experiences in urology offices over the years, and we are sensitive to that. The final treatment plan is then created and tailored to the individual and her needs and more importantly the symptom that is bothering her the most.
Regardless of whether a woman opts for treatment or not, we believe it is very important to have annual follow up and surveillance of the urinary tract given the fluctuating nature of some of the neurological conditions and the changes that can occur.
Bladder Botox Injections
The use of Botox in urology is approved by the FDA and many studies have found its useful potential in relieving a variety of lower urinary tract dysfunctions including multiple sclerosis, stroke, overactive bladder, interstitial cystitis, and spinal cord injury when conventional treatments have failed.
A cystoscopy is a procedure that is used to visually inspect the bladder.
Pelvic Floor Dysfunction
Pelvic floor dysfunction (PFD) is a general term used to describe when the nerves and muscles supporting the pelvis and vagina are not coordinated with bladder, bowel or sexual function.
In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is used for organs protruding through the vagina or the rectum.
Stress incontinence is urinary incontinence/leakage with activity. Some common symptoms are leaking with coughing, laughing, sneezing or exercise.
Urodynamics is a collective group of tests that allows us to study how your lower urinary tract works. Your lower urinary tract includes the bladder, which stores your urine, and the urethra which is the tube that carries urine from your bladder to the outside of your body.