BOTOX FOR OAB: PATIENT BROCHURE
Many people have heard of Botox for cosmetic wrinkle removal, but have you heard of Botox injection in the bladder for urinary frequency, urgency, and urge incontinence? These symptoms are at the core of what urologists term ‘overactive bladder’ or OAB. The first line of treatment is usually medication that relaxes the bladder. These bladder calming medications are called anticholinergics. They are great medications to begin with because they are easy to prescribe and easy to take. These medications include oxybutynin, tolterodine, and several others. You usually have to take these medications several times a day, they cause dry mouth and constipation, and in a small percentage of people, these medications may cause urinary retention. Additionally, these medications only work the day that you take them which is both good for short term treatment, but bad for long term management.
Botox for OAB also calms the bladder by relaxing bladder muscle, but it does so with more efficiency and intensity. Botox is a toxin that doesn’t allow the bladder muscle receptors to activate, and thereby prevents tightening of the muscle fiber. Botox does this with great efficacy and a little bit of Botox goes a long way.
Botox for OAB works only on the bladder muscle, so side effects such as dry mouth, constipation, and dizziness do not occur. The Botox injection for the bladder is usually done in the office with local anesthesia, and takes just 10–15 minutes for the procedure. The total time you are in the office is about 60 minutes to allow for preparation. However, there is still a chance for urinary retention and urinary tract infection because it is a medication that prevents a small portion of the bladder wall from tightening or contracting. Botox for OAB also requires redosing because the effect usually will wear off 4–6 months after an injection.
There is another procedure called Inter-Stim which is also used for OAB, but this procedure requires an implantable neurostimulator. However, if a patient fails either Botox or anticholinergics, then Inter-Stim is another great option.
Dr. Michael Louie is an assistant clinical professor of Urology at the University of California, Irvine Department of Urology. He co-wrote the first chapter in the definitive textbook for robotic renal surgery, Robotic Kidney Surgery, edited by Dr. Ronney Abbaza. Dr. Louie has many publications and has written chapters in multiple textbooks including biomaterials, ureteral stone management, and robotic pyeloplasty.
If you would like a copy of the textbook, here is a link on Amazon: www.amazon.com/Robotic-Renal-Surgery-Kidneys-Ureters/dp/1461465214
We had our grand opening of Louie Medical Group at our new satellite location in Upland today! Our office is located at 811 E. 11th St., Ste 102, Upland, CA. Our patients love the ease of getting into the office now that there’s plenty of parking and plenty of seating in the reception. If you are interested in an appointment at this location, please call us at 909−627−8521 or have your referring physician send a fax to 909−563−8202.
We are happy to announce that we are near completion of opening our second location in Upland, CA. You can call to make or change your appointment to this location now! 909−627−8521.
New Upland, CA address for Louie Medical Group where Dr. Michael Louie, Dr. Boonsong Anan, and Sheila Bobis MS, PA-C will be seeing patients:
811 E. 11th St., Ste. 102, Upland, CA 91786
PRINTABLE PDF: Upland office map and hours
What is commonly known as BPH or benign prostatic hyperplasia, is the natural enlargement of the prostate with age. Not all enlarged prostates progress to cause urinary problems, but many men suffer from difficulty with urination. These symptoms might include night time urination, straining to urinate, having to wait for the urine stream to start, having a weak urine stream, or even urinary frequency or urgency. When these symptoms get bothersome ie affect your quality of life, then it’s time to start thinking about treatment. Most men will start on alpha blocker therapy which are medications to relax the prostate and allow urine to pass by easier. A smaller number of men with even larger prostates may additionally take a prostate shrinking medication such as Avodart or Proscar. While medical therapy has revolutionized our treatment of BPH and decreased the number of men requiring surgery, all medications have side effects and these medications are no exception. Side effects such as retrograde ejaculation, fatigue, orthostatic hypotension, decreased sexual desire, and erectile dysfunction can be attributed to the medications. Additionally, these medications may take several weeks to months to affect your urination.
For patients who do not want to suffer these side effects, remember to take a pill, or who wish to have immediate improvement, a parallel path to voiding freedom is to undergo a minimally invasive prostate procedure. An astute reader may be thinking about microwave therapy on the prostate, but I can honestly say that the results from in office prostate microwave therapy has been disappointing, and therefore I could not recommend it. BPH procedures I recommend for an enlarged obstructing prostate are the button plasmavaporization (“button TURP”) by Olympus, the Greenlight photovaporization of the prostate (“laser TURP” or PVP) procedure by American Medical Systems, the holmium laser enucleation of the prostate (HoLEP) endorsed by Lumenis, and the robotic simple prostatectomy. Most urologists only offer 1 or 2 methods of prostate surgical treatment, but I have been specially trained and am experienced in each of the BPH procedures mentioned. I do not offer all the procedures to every patient, but can match the procedure with the patient’s expectations, goals of treatment, and concerns about side effects. If you have read this far, you definitely want to know more about BPH and BPH treatments. Go to this page: BPH and BPH Treatments.
Two weeks have passed in the New Year and many wonderful things are happening in the practice:
1) WE PASSED! The medical practice passed Stage 1 of Medicare’s Meaningful Use criteria for use of an accredited and certified Electronic Medical Record (EMR). Many of you know that since October 2012, we chart/write prescriptions/schedule/manage billing through our new computer systems. We had a rocky start (like all software implementation), but are smoothing out a lot of the day to day work on the computers. We use InSync by Intivia, and it has been a great system so far.
2) This is not completely separate, (but a huge win for me) we are now fully on electronic medical records at our UPLAND location. This has been some time coming, but this allows total integration with our Chino office.
3) Vasectomy week is filling up! I’m excited to be able to provide this service to families that are wanting permanent effective birth control.
4) I promise to update the site and blog every week. This is scary because now that this commitment is out there, I can’t take it back.
5) Last, but not least, THANK YOU to the patients, doctors, and community support since I started my practice in Chino. This has been an exciting transition and wonderful beginning!
For all those football fans, get a prescription for couch time to watch SUNDAY’S CHAMPIONSHIP GAME! We are having a vasectomy week leading up to the BIGGEST FOOTBALL GAME OF THE YEAR! If you have been putting off having a vasectomy or have not found time to do it, then why not make the most of the recommended recovery and couch potato time after the vasectomy?
A vasectomy is a form of permanent birth control by stopping sperm from leaving the body. It is a quick, in-office procedure that will relieve you and your partner of contraception worries! Call us at 909−627−8521 to schedule a consultation or email us! Go to vasectomy.louiemedical.com for more information about the procedure.
I have been in private practice for almost 3 months and everything is going extremely well. While I knew that the medical side of things would be fairly straightforward with 10 years of training and practicing urology under my belt, it surprises me everyday the extent of mundane and painful tasks of running a business. From ordering the correct amount of copy paper, tissue boxes, and biopsy needles, to getting the EMR and IT services to talk and move forward. One of the most painful of these new adventures has been the installation of FIOS service. Everything used to work just fine, but now with FIOS, everything had to be changed or altered and my old credit card machine does not ‘talk’ to to the service center. ARGH! The great thing about FIOS is my internet speed is now incredible and reliable. Despite many hours holding and talking to Verizon, they do not think it is their problem, but I’m not sure how they can determine that without a visit to our office. Call it what you want, but advancing technology is NOT PLUG AND PLAY. I’m becoming more of a believer in dictatorial technology like APPLE controlling all their hardware so that things work.
It’s been a month since first joining Dr. Boonsong Anan in practice here in Chino. It’s been pretty much what I expected, except for one thing: we drive a lot. As private practice physicians, most people don’t realize that we don’t just sit in one office all day and wait for patients to show up. We drive to 6 different hospitals and 2 office locations. Not usually in one day, but it’s possible! Despite the mileage on the car, I’m buoyed by the wonderful reception I have received from the patients I am getting to know and from the local doctors who refer to me.
I’m excited to start my practice in Chino and to work with an amazing team! On my blog, I’ll post monthly on interesting topics that I run across related to urology and anything related to health care in general, the business and legislation of medicine, and sometimes I’ll post fun stuff like fishing and new technology.