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:
- Neurogenic causes such as Multiple Sclerosis.
- 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!
- 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.
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