OnabotulinumtoxinA Injections for the Treatment of Myofascial Pelvic Pain: 12-Year Experience at a Tertiary Care Academic Center.
Gynecol Obstet Invest
; 88(1): 37-46, 2023.
Article
en En
| MEDLINE
| ID: mdl-36577396
ABSTRACT
OBJECTIVE:
The aim of this study was to highlight the safety of OnabotulinumtoxinA (BTA) injections, with or without concurrent pudendal nerve block, in treating women with myofascial pelvic pain (MFPP).DESIGN:
This was a retrospective cohort study.SETTING:
The review was conducted in a tertiary care academic center. Participants/Materials We conducted a chart review of patients who were diagnosed with MFPP and treated with BTA with or without pudendal nerve block between January 2010 and February 2022.METHODS:
BTA was injected transvaginally into the pelvic floor muscle group. The primary outcomes were adverse events after BTA injections, and the secondary outcome was the effect of concomitant pudendal nerve block at the time of BTA injections.RESULTS:
The cohort included 182 patients; 103 (56.6%) received BTA injections with pudendal nerve block, and 79 (43.4%) received BTA alone. There were no significant demographic differences between the two groups. Post-treatment complications of BTA administration included worsening of pelvic pain (11.5%), constipation (6.6%), urinary tract infection (2.7%), urinary retention (3.8%), and fecal incontinence (2.7%). No statistical difference was noted in the number of phone calls, patient-initiated electronic messages, emergency room visits, or clinic visits for both groups within 30 days post-treatment. The mean number of total injections was 1.6 in the BTA-only group and 1.7 in the BTA with pudendal block group (p = 0.421). Median time to re-intervention with a second BTA injection was 6.0 months; 5.6 months in the BTA with pudendal block group; and 6.8 months in the BTA-only group, p = 0.46. There were 63 re-intervention events after BTA injections.LIMITATIONS:
Limitations of our study include the retrospective design making it vulnerable to missing or incomplete data available for review.CONCLUSION:
OnabotulinumtoxinA is beneficial in treating women with MFPP; with a duration of therapeutic effect of approximately 6 months. The use of a concurrent pudendal nerve block did not impact clinical outcomes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Toxinas Botulínicas Tipo A
/
Nervio Pudendo
/
Síndromes del Dolor Miofascial
Tipo de estudio:
Observational_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
Gynecol Obstet Invest
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos