Treatment of Dyspareunia with Botulinum Neurotoxin Type A: Clinical Improvement and Influence of Patients’ Characteristics

Marta Tarazona-Motes, Monica Albaladejo-Belmonte, Francisco J. Nohales-Alfonso, Maria De-Arriba, Javier Garcia-Casado and Jose Alberola-Rubio
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Marta Tarazona-Motes: Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe de Valencia, 46026 Valencia, Spain
Monica Albaladejo-Belmonte: Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Edif. 8B, Camino de Vera SN, 46022 Valencia, Spain
Francisco J. Nohales-Alfonso: Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe de Valencia, 46026 Valencia, Spain
Maria De-Arriba: Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe de Valencia, 46026 Valencia, Spain
Javier Garcia-Casado: Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Edif. 8B, Camino de Vera SN, 46022 Valencia, Spain
Jose Alberola-Rubio: Unidad de Bioelectrónica, Procesamiento de señales y Algoritmia, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain

IJERPH, 2021, vol. 18, issue 16, 1-12

Abstract: The treatment of chronic pelvic pain (CPP) with botulinum neurotoxin type A (BoNT/A) has increased lately, but more studies assessing its effect are needed. This study aimed to evaluate the evolution of patients after BoNT/A infiltration and identify potential responders to treatment. Twenty-four women with CPP associated with dyspareunia were treated with 90 units of BoNT/A injected into their pelvic floor muscle (PFM). Clinical status and PFM activity were monitored in a previous visit (PV) and 12 and 24 weeks after the infiltration (W12, W24) by validated clinical questionnaires and surface electromyography (sEMG). The influence of patients’ characteristics on the reduction in pain at W12 and W24 was also assessed. After treatment, pain scores and the impact of symptoms on quality of life dropped significantly, sexual function improved and sEMG signal amplitude decreased on both sides of the PFM with no adverse events. Headaches and bilateral pelvic pain were risk factors for a smaller pain improvement at W24, while lower back pain was a protective factor. Apart from reporting a significant clinical improvement of patients with CPP associated with dyspareunia after BoNT/A infiltration, this study shows that clinical characteristics should be analyzed in detail to identify potential responders to treatment.

Keywords: botulinum toxin; dyspareunia; chronic pelvic pain; surface electromyography (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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