Botulinum Toxin Type A for Chronic Pain and Pelvic Floor Spasm in Women

Abstract

Australian Clinical Trials Registry, http://www.actr.org.au/, ACTRN012605000515695 LEVEL OF EVIDENCE: I.

Botulinum Toxin for Vaginismus Treatment

“…A previous systematic review pointed this out, indicating that controlled trials of treatments for vaginismus are needed [9,11]. Nevertheless, results observed in this meta-analysis are in agreement with at least 3 other studies that have also found results indicating the effectiveness of botulinum toxin to treat other disorders associated with the pelvic floor musculature such as postoperative dyspareunia [23], pelvic floor spasm [24], and vulvodynia [25]. Furthermore, Pacik [11] has reported ‘success rates in excess of 90%’ in an unpublished sample of 81 patients.…”

Antinociceptive effect of botulinum toxin type A on experimental abdominal pain

“…It was found that local BTX-A injections efficiently decrease pain in patients suffering from bladder pain syndrome/ interstitial cystitis, prostatitis and pelvic-floor muscle disorder (Abbott et al, 2006., Chung et al, 2012, El-Khawand et al, 2013, Gottsch et al, 2011, Kuo, 2013, Pinto et al, 2013, Smith et al, 2004, Zermann et al, 2000. In addition, there are isolated case reports on the beneficial effect of BTX-A on non-cardiac chest pain (Maradey-Romero and Fass, 2014) and perineal pain (Lim et al, 2010).…”

Neurotoxin Use for Voiding Dysfunction

“…Abbott et al [18] reported their double-blind, randomized, placebo-controlled trial of botulinum neurotoxin injection in patients with chronic pelvic pain of more than 2 years' duration and evidence of pelvic floor muscle spasm. Patients received 80 U of onabotulinumtoxinA (n= 30) or saline injection (n=30) into the pubococcygeus and puborectalis muscles.…”