Botulinum toxin type A for the treatment of provoked vestibulodynia: an open-label, pilot study.
OBJECTIVE
To evaluate the effects of botulinum toxin type Afor the treatment of provoked vestibulodynia.


METHODS
Open-label, dose-escalation, pilot study. Primary outcome measure was a standard numeric pain rating scale of 0-10. Secondary measures were improvements in quality of life and change in medication use.


RESULTS
The 7 patients who received 35 units of botulinum toxin type A had a baseline mean pain score (0-10) of 8.1 (SD = 0.70). Thirty days after treatment, these patients had a mean pain score of 2.9 (SD= 1.17). The duration of effect was 8 weeks, and there were no side effects. The 12 patients who received 50 units of botulinum toxin type A had a baseline mean pain score of 7.4 (SD = 0.10). Thirty days after treatment, these patients had a mean pain score of 1.8 (SD= 0.72). The duration of effect was 14 weeks, and there were no side effects. Significant improvement was also seen in medication use and quality of life for these patients.


CONCLUSIONS
This study provides further clinical evidence of the nociceptive effects of botulinum toxin type A in pelvic inflammatory pain-related disorders. Doubleblind, placebo-controlled trials to evaluate the efficacy of botulinum toxin in treating patients with provoked vestibulodynia are warranted.
Dykstra
Dennis D
DD
Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis 55455, USA. dyskt001@umn.edu
Presthus
James
J
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008875:Middle Aged; D009498:Neurotoxins / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy*; D010865:Pilot Projects; D014845:Vulvar Diseases / Q000188:drug therapy*
D009498:Neurotoxins; D019274:Botulinum Toxins, Type A