title: Simplified technique for injection of Botulinum Toxin to Obturator Internus muscle using ultrasound-guided nerve stimulation for persistent pelvic pain.
abstract: Botulinum toxin (BoNT) injections have been used to reduce muscle spasm in the presence of severe pelvic pain. However, while pubococcygeus is easily accessed vaginally, injection to obturator internus is more complex - with variation in operative technique and needle placement confounding the ability to assess outcomes. We describe a simplified technique for BoNT injection to obturator internus using neurostimulation under ultrasound guidance.
authors.affiliation: Gynaecology, Pain Medicine, Pelvic Pain SA, Norwood, Australia.
authors.forename: Susan Florence
authors.initials: SF
authors.lastname: Evans
authors.affiliation: Pulse Anaesthetics, Rose Park, South Australia, Australia.
authors.forename: Justin Matthew
authors.initials: JM
authors.lastname: Porter
mesh_terms: D000577:Amides; D000768:Anesthesia, General; D000779:Anesthetics, Local; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D009339:Needles; D009407:Nerve Block; D017699:Pelvic Pain / Q000188:drug therapy*; D060525:Pudendal Nerve; D000077212:Ropivacaine; D018084:Ultrasonography, Interventional
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA
keywords: botulinum toxin; neurostimulation; obturator internus; pelvic pain; persistent pain; ultrasound-guided injection