Botulinum injections for myofascial pelvic pain

Toozs‐Hobson, Philip; Roper, Joanna C; Gurung, Sabitra; Brair, Amallia; Bach, Fiona

doi:10.1007/s00192-020-04435-w

Cited by 5 publications

(6 citation statements)

References 28 publications

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“…com/AOG/D419). 13,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] Prospective data showed significant improvements in patient-reported outcomes after botulinum toxin in all studies. Of the eight studies that reported the non-patient-reported outcomes of vaginal manometry or physical examination findings, seven reported significant improvements in vaginal pressure or pelvic floor hypertonicity at clinical examination.…”

Section: Resultsmentioning

confidence: 82%

“…Qualitative analysis was performed on 14 prospective and four retrospective studies involving a total of 600 and 204 participants, respectively (Appendices 2 and 3, available online at http://links.lww.com/AOG/D419). 13,34–50 Prospective data showed significant improvements in patient-reported outcomes after botulinum toxin in all studies. Of the eight studies that reported the non–patient-reported outcomes of vaginal manometry or physical examination findings, seven reported significant improvements in vaginal pressure or pelvic floor hypertonicity at clinical examination.…”

Section: Resultsmentioning

confidence: 87%

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Botulinum Toxin for the Management of Pelvic Floor Tension Myalgia and Persistent Pelvic Pain

Knapman,

Li,

Deans

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To systematically review the literature on use of botulinum toxin to treat pelvic floor tension myalgia and persistent pelvic pain. DATA SOURCES: The ClinicalTrials.gov, PubMed, EMBASE, and Scopus databases were searched from inception to November 2022 by two independent assessors (B.L.K. and F.G.L.). Identified studies were screened by title and abstract and included after full-text review. Data extraction was subsequently performed and recorded in Microsoft Excel. METHODS: This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines after registration in PROSPERO (CRD42022289132). All randomized studies, prospective studies with more than five participants, and retrospective studies with more than 10 participants published in English or French and assessing the use of botulinum toxin for the treatment of pelvic floor tension myalgia and persistent pelvic pain in women were included. Meta-analyses were performed on randomized data. TABULATION, INTEGRATION, AND RESULTS: Of 4,722 articles identified, 24 satisfied inclusion criteria. A meta-analysis of five randomized controlled trials totaling 329 participants demonstrated no differences in patient- and clinician-reported outcome measures, including pain, dyspareunia, sexual function, and vaginal manometry. Mean duration of follow-up was 6 months. A qualitative analysis of 14 prospective and four retrospective studies including 804 participants is supportive of botulinum toxin; however, the quality of data is low, and there is marked heterogeneity between studies. CONCLUSION: Meta-analyses of randomized data do not support the use of botulinum toxin to treat pelvic floor tension myalgia and persistent pelvic pain. Failure of these data to confirm the findings of nonrandomized prospective studies that suggest a treatment benefit may be attributable to the absence of placebo control and confounding outcomes obtained from an active comparator group. Further randomized controlled trials with true placebo are strongly recommended. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42022289132.

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Section: Resultsmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 87%

Botulinum Toxin for the Management of Pelvic Floor Tension Myalgia and Persistent Pelvic Pain

Knapman,

Li,

Deans

et al. 2023

Obstetrics &Amp; Gynecology

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“…A recent retrospective study by Jha et al assessed the impact (PGI-I) of BTA treatment. This paper demonstrated improvement (very much better and much better) in symptoms in 72% of women after one or multiple BTA injections [ 29 ]. However, no additional analysis was performed to differentiate between one or multiple injections.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of botulinum toxin a injections in pelvic floor muscles in chronic pelvic pain patients: a systematic review and meta-analysis

et al. 2022

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Introduction and hypothesis Chronic pelvic pain (CPP) is a common multifactorial condition affecting 6 to 27% of women aged 18–50 years worldwide. This study was conducted to review and meta-analyse the current literature on the reduction of chronic pelvic pain after botulinum toxin A (BTA) injection. Method In July 2021 we performed a systematic search in PubMed and EMBASE to assess the benefits of BTA injection in pelvic floor muscles in women with chronic pelvic pain. Primary outcome was reduction in visual analogue scale (VAS) after treatment. Secondary outcomes evaluated were: reduction of dyspareunia, pelvic floor resting pressure and quality of life. Identified reports were assessed on quality of reporting and risk of bias. Standardized mean difference (SMD) was used to combine and analyse outcomes of the included studies. Results Eight studies with 289 participants were considered eligible to be included in this systematic review and meta-analysis. After recalculating SMD into VAS scores (0–100), long-term follow-up (24–26 weeks) showed a significant 15-point improvement in VAS scores (95% CI: 8.8–21.5) for non-menstrual pelvic pain and a 13-point improvement (95% CI: 2.1–24.0) for dyspareunia. BTA injection had a significant effect on pelvic floor resting pressure and quality of life. Conclusion There is limited scientific evidence on the effectiveness of BTA injections in pelvic floor muscles in women with chronic pelvic pain. The available studies show that BTA injections significantly reduce pain levels and improve quality of life at 6 months follow-up. Prospero ID CRD42018105204.

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“…An alternative strategy may be to directly target the nerves involved in the pain pathways. For example, injections of neurotoxin (Onabotulinum) have been used to treat women with chronic pelvic pain associated with myofascial pelvic pain (MFPP) syndrome with 74% of patients reporting an improvement in symptoms (Jha et al, 2020). A link between the chronic pelvic pain experienced by women with endometriosis and myofascial trigger points has been proposed, opening up a new therapeutic target (Aredo et al, 2017).…”

Section: Novel Therapies Targeting Endometriosis As a Pain Disordermentioning

confidence: 99%

Endometriosis: Etiology, pathobiology, and therapeutic prospects

Saunders

Horne

2021

Cell

392

389

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Botulinum injections for myofascial pelvic pain

Cited by 5 publications

References 28 publications

Botulinum Toxin for the Management of Pelvic Floor Tension Myalgia and Persistent Pelvic Pain

Botulinum Toxin for the Management of Pelvic Floor Tension Myalgia and Persistent Pelvic Pain

The efficacy of botulinum toxin a injections in pelvic floor muscles in chronic pelvic pain patients: a systematic review and meta-analysis

Endometriosis: Etiology, pathobiology, and therapeutic prospects

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