www.incontinentsupport.org

I have been over analyzing my future with my bladder to the point I ended up contacting both my Psychologist and Psychiatrist to make sure I am not made about wanting to be made completely Urinary incontinent without any external devices.

Blader treatment options pros and cons

1. Botox to Urethral sphincter and bladder neck might not work.
- Every 6ish months
- Reduced workload 6 weeks afterward every time post-OP
- Reduces efficiency over time.

2. Indwelling Catheter (cant Intemedite self cath due to essential tremors etc)
- Falls risk I should be using a wheelchair a lot more often due to my spine and feet but it is not OH&S-friendly for support workers who require mobility scooters.
- Will take time to adjust to wheelchair/ mobility scooter as will be more reliant over time due to spine and feet according to Neurosurgeon, Podiatrist, EP, Physio
- Multiple falls to the bathroom.
- Bulky does not fit under clothes well
- Fear of dislodgement if fall
- Has to be changed approximately every 3 months government is already paying for briefs and it is unlikely for nursing to change IDC.
- Possible won't be able to masturbate/sexual encounters or exercise much except swimming with a flip flow.
*POSITIVE- Am completely urinary incontinent for short periods no Frequency, controlled leakage, no retention NO NUMERMOUS FALLS TO BATHROOM AT NIGHT.

3. If able to make the Bladder itself incontinent (My wish)
- Once off
- Already have briefs that are more discrete than IDC.
- Already previously advised by OTs, StateHealth clinical staff to use Briefs in bed due to fall risk. (Bladder is uncooperative regarding this as well as urinal bottle etc.
- Possibly fewer infections than IDC and cath,
- Briefs help with bowel marks (which I think is blood about to have a gastroscopy and colonoscopy done (the Gastrologist thinks I have IBS Constipation after initial appointment) as well as excessive sweating.

Are there any pros or cons I am missing

Thanks

Good luck with your Botox questions issues. I had my first Botox injections in 1998; my experience was that they wore off after successively shorter and shorter periods of time, necessitating my first sphincterotomy in August, 1999. I subsequently had another sphincterotomy in January, 2021. No Botox this time. If you understand that the Botox injections, and subsequent sphincterotomy will leave you almost totally incontinent, and are prepared psychologically and physically to manage life as an incontinent, go for it. My choice was diapers or dialysis; I chose diapers, and have had no second thoughts.

Are you prone to uti's backflow issues / other bladder/kidney issues etc?

No. I was afraid that my first sphinctrotomy would make my bladder vulnerable to infections, but that never happened. I do what I need to do to manage, and my family are supportive, though I try to minimize my intrusion into their situations.

What form does the incontinence take when you have a sphincterotomy? Is it a trickle or is it reflex voiding?

My experience post-sphincterotomy has been that I leak continually, interspersed by forceful urination following consuming too much fluid too fast, under conditions, such as moderate weather, when I do not perspire enough to ease the burden on my kidneys. I also experience occasional bowel incontinence, which, together with urinary incontinence, make diapers necessary.

OMFG

I forgot how refreshing water is without bladder spasms/feelings etc since I have the IDC in I am going to request to keep it in til 22 May when I see urologist as looks like I have Nosturnia as well as previous continence nurses have suggested.

I don't have any experience with making yourself incontinent (my accident did that for me) but I definitely have experience with catheters. I tried intermittent cathing and had an SPC. I tried everything to keep me out of diapers. I was absolutely miserable. I had tons of infections. When I had a leg bag it fell out during PT (embarrassing). I for the life of me could not get the timing right for the flip flow so I was still peeing myself. It was horrible. I had the thing taken out, went back to diapers and have not looked back.

I'm a wheelchair user too and also an amputee (with a host of other medical issues) and am a huge fall risk. I empathize.

I am not going to try as far as I understand I have overflow incontinence and issues with retention and Nocternia due to either Sphinter or bladder neck (which he botoxed) which is not a long term solution if it works as well as injuring myself getting to bathroom numerous times per night due to falls and the interrupted sleep has consequences on my Bipolar, autism and other things.

I also don't want an external cath and cant self cath due to essential tremors in hands and my mobility is deterioating :'(