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Botulinum toxin is a safe, well-tolerated and effective
treatment approach for women with chronic pelvic pain disorders.
The botulinum toxin (BoNT) can be safely injected into
pelvic floor muscles in women as an out-patient method as described in a study
issued in 'International Urogynecology Journal'. Botulinum toxin (BoNT) offers
pain relief, particularly in a muscle spasm. Karp BI and team carried out the
present study to explore the effectiveness of BoNT therapy in women with
chronic pelvic pain (CPP). The database search was performed
using the terms "pelvic pain," "botulinum toxin and
"vaginismus." The "vaginismus/vulvar pain disorders"
(V/VPD) comprised of reports on vaginismus/vulvodynia/vestibulodynia
(considered if pelvic floor muscles were injected).
Points examined:
For specific analyses, the journal papers written by the
same authors with similar information were consolidated. Although many reports
lacked complete information, 38 reports had analyzable information.
The
analyzed
reports included:
The transvaginal, transperineal and/or transgluteal comparison of pelvic floor muscles was carried out. The BoNT brand/dose/dilution varied throughout. Some methods such as electromyography, anatomical landmarks, fluoroscopy/CT scanning and electrical stimulation with/without ultrasound were used as muscle localization techniques. The papers addressing analgesia used conscious sedation with/without topical/local anaesthesia, general anaesthesia, topical/local agent alone or pudendal block before or after the injection. There was significant improvement in 58-100% of patients with CPP and 71-100% of patients with V/VPD. With higher doses, severe adverse effects like urinary incontinence/retention and transient faecal incontinence/constipation were observed.
The present research recognises methodological determinants to be explored in
further studies and the significant need for high-quality clinical trials for
this forthcoming treatment approach.
International Urogynecology Journal
Methodological approaches to botulinum toxin for the treatment of chronic pelvic pain, vaginismus, and vulvar pain disorders
Karp BI et al.
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