Subjective and objective outcomes of botulinum toxin type A treatment in vestibulodynia

Pilot data

Candace Brown, Howard I. Glazer, Val Vogt, Daniel Menkes, Gloria Bachmann

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVE: To collect pilot data on the efficacy of intramuscular botulinum toxin type A (BTX/A) injection into the levator ani muscles to relieve coital pain, reduce pelvic floor tension and instability, and reduce vestibular hyperalgesia in vestibulodynia. STUDY DESIGN: Two subjects meeting diagnostic criteria for vestibulodynia were treated with 20 units and 40 units of BTX/A at 12-week intervals. Outcomes included a visual analogue scale (VAS), weekly coital pain diaries, surface electromyography (sEMG) and a vulvar algesiometer. RESULTS: BTX/A modestly reduced coital pain in 1 patient and was ineffective in the other. Pelvic floor hypertonicity and variability were markedly reduced in both patients, but negligible changes occurred in vestibular hyperalgesia. The patient with greater pelvic floor tension had more of a reduction in diary-rated coital pain 2 weeks after the injection (29% vs. 9%) and on the VAS at 12 weeks (15% vs. 3%). CONCLUSION: BTX/A injections may be effective in reducing coital pain in vestibulodynia with levator ani tenderness but have little effect on vestibular allodynia. The relationship between pelvic floor hypertonicity and decreased coital pain suggests that vestibulodynia may be a variant of chronic regional pain syndrome. The dose and volume of BTX/A injected may be related to the degree of relief.

Original languageEnglish (US)
Pages (from-to)635-641
Number of pages7
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume51
Issue number8
StatePublished - Aug 1 2006

Fingerprint

Vulvodynia
Type A Botulinum Toxins
Pelvic Floor
Pain
Hyperalgesia
Anal Canal
Visual Analog Scale
Injections
Therapeutics
Electromyography
Chronic Pain
Muscles

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Subjective and objective outcomes of botulinum toxin type A treatment in vestibulodynia : Pilot data. / Brown, Candace; Glazer, Howard I.; Vogt, Val; Menkes, Daniel; Bachmann, Gloria.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 51, No. 8, 01.08.2006, p. 635-641.

Research output: Contribution to journalArticle

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