Botulinum Toxin for Vaginismus Treatment

Abstract

Background/Aims: Vaginismus is characterized by recurrent or persistent involuntary contraction of the perineal muscles surrounding the outer third of the vagina when penile, finger, tampon, or speculum penetration is attempted. Recent results have suggested the use of botulinum toxin for the treatment of vaginismus. Here, we assessed previously published data to evaluate the therapeutic effectiveness of botulinum toxin for vaginismus. Methods: We have carried out a systematic review followed by a meta-analysis. Results: Our results indicate that botulinum toxin is an effective therapeutic option for patients with vaginismus (pooled odds ratio of 8.723 with 95% confidence interval limits of 1.942 and 39.162, p = 0.005). This may hold particularly true in treatment-refractory patients because most of the studies included in this meta-analysis have enrolled these subjects in their primary analysis. Conclusion: Botulinum toxin appears to be a reasonable intervention for vaginismus. However, this conclusion should be read carefully because of the deficiency of placebo-controlled randomized clinical trials and the quality issues presented in the existing ones.

Abordagens Terapêuticas Em Pacientes Com Vaginismo: Uma Revisão De Literatura

“…Porém, seria preciso de mais estudos clínicos randomizados e com grupo controle por placebos para maior comprovação da eficácia. 30 Não obstante, o artigo de Well, Farah (2009) que teve como base a análise de outros cinco estudos em que se foi observado o uso de toxina botulínica para o tratamento do vaginismo, concluiu que o uso de toxina botulínica em comparação ao placebo não houve uma redução significativa da dor em nenhum dos estudos em questão. O estudo também afirma a superioridade de resposta terapêutica quando comparada a fisioterapia isolada à toxina botulínica isolada.…”

Cosmetic gynecology—An emerging field for the dermatologist

“…Meta‐analysis has shown that boutlinum toxin is a useful technique for patients not responding to usual line of treatment 25 …”

An Interdisciplinary Approach to Endometriosis-associated Persistent Pelvic Pain

“…For PF trigger points, treatment options include local anaesthetic or Botox A injection. A meta-analysis indicated that there is evidence for the use of Botox in women with vaginismus (76). Local medical therapy such as vaginal diazepam 2.5–10 mg once or twice daily, may be used, but evidence on this is mixed (77–79) and systemic absorption is an issue (78).…”