There are several types of bladder instillation on the market - I often recommend a citric acid solution twice a week. I also find an "open-tipped" catheter can be useful in this situation. I do have a handful of patients that need SPC changes every 4-6 weeks despite these measures.

The use of daily low dose antibiotics will reduce the risk of UTI associated with self-catheterisation by about 50% - data from the ANTIC trial. Non-antibiotic preventative strategies would include Methenamine Hippurate, D-mannose, Cranberry supplements and intravesical treatments - however these ha...

The best data on bulkamid comes from this study
https://pubmed.ncbi.nlm.nih.gov/31479396/
It shows that bulkamid has a high satisfaction and cure rate but not as high as other more invasive options.

There are a range of treatments available for your condition. Perhaps you need an appointment with a urologist with an interest in this condition to allow you to decide which treatment you might like to try.

There are lots of other tablet treatments available as well as some transdermal (skin patch) preparations. You can discuss alternatives with your GP. There is a tablet called Mirabegron which doesn't associate with poor bladder emptying and this may suit you.

Sounds like you need a consultation with a functional urologist and stoma specialist before you make a decision regarding bladder removal. You are correct to assert that bladder removal is usually a last resort treatment and you need to discuss all options first.

In a word "yes". Botox is an excellent treatment for overactive bladder symptoms secondary to neurological disease like a stroke - it may be that the original dose could be increased?

If you have had bladder outlet obstruction diagnosed (presuming this because you are on Tamsulosin) then this can be a cause of the symptoms you describe. Saw palmetto is a natural product that may shrink the prostate and reduce your symptoms but the evidence to support its use is patchy. In about 2...

Perhaps you should talk to a urologist about sacral neuromodulation if you are not keen on Botox. Just to clarify Botox is not associated with impotence.

Sometimes urge incontinence can develop after prolapse surgery and your history is suggestive. A continence advisor would be the logical first step for you and can be accessed via your GP.