Long-term assessment of effectiveness and quality of life of OnabotulinumtoxinA injections in provoked vestibulodynia.
BACKGROUND
Provoked vestibulodynia is a relatively common condition that affects sexual activity. Multidisciplinary care is indicated and OnabotulinumtoxinA injections are safe and effective treatment in this indication.


OBJECTIVE
To assess the long-term efficacy of OnabotulinumtoxinA in provoked vestibulodynia.


METHODS
Twenty-one patients treated with OnabotulinumtoxinA injections (50U in each bulbospongiosus muscle) 24 months prior to the study were included. Data on pain [assessed using a visual analogue scale (VAS)], quality of life [measured by the Dermatology Life Quality Index (DLQI)] and quality of sex life [assessed using the Female Sexual Function Index (FSFI)] were collected before treatment, and 3 and 24 months after injection.


RESULTS
Nineteen patients participated in the study and 37% had no pain after 24 months. Significant improvements were noted in the VAS, DLQI and FSFI scores between baseline and 24 months post treatment (P < 0.0001). After 24 months, 18 patients (95%) were able to have sexual intercourse. This study was open and non-controlled.


CONCLUSIONS
100U OnabotulinumtoxinA injections constitute an effective treatment in provoked vestibulodynia with results maintained after 2 years. They significantly improve pain, and have a positive impact on patient quality of life and sex life. Beneficial effects continue in the long-term, allowing patients to resume sexual activity.
Department of Dermatology, Besançon University Hospital, Besançon, France.|INSERM UMR1098, University of Franche-Comté, Besançon, France.
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F
Pelletier
Department of Dermatology, Besançon University Hospital, Besançon, France.
M
M
Girardin
Department of Dermatology, Besançon University Hospital, Besançon, France.|INSERM UMR1098, University of Franche-Comté, Besançon, France.
P
P
Humbert
Clinical Methodology Centre, Besançon University Hospital, Besançon, France.
M
M
Puyraveau
Department of Dermatology, Besançon University Hospital, Besançon, France.|University of Franche-Comté, Besançon, France.
F
F
Aubin
Department of Physical Medicine and Readaptation, Besançon University Hospital, Besançon, France.|Anatomy Laboratory, University of Franche-Comté, Besançon, France.
B
B
Parratte
D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D010147:Pain Measurement; D011788:Quality of Life; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D056650:Vulvodynia / Q000188:drug therapy*
D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A