Efficacy of high doses of botulinum toxin A for treating provoked vestibulodynia.
Fiche publication
Date publication
mars 2011
Auteurs
Membres identifiés du Cancéropôle Est :
Pr AUBIN François, Pr HUMBERT Philippe
Tous les auteurs :
Pelletier F, Parratte B, Penz S, Moreno JP, Aubin F, Humbert P
Lien Pubmed
Résumé
BACKGROUND: Provoked vestibulodynia is difficult to treat. The beneficial effects of botulinum toxin A are being considered because of the muscular anomalies observed in this pathology. OBJECTIVE: To evaluate the efficacy of botulinum toxin A in the treatment of provoked vestibulodynia. METHODS: Patients aged between 18 and 60 years presenting with provoked vestibulodynia (according to the 2003 International Society for the Study of Vulvar Disease classification) received 50 U of botulinum toxin A bilaterally in the bulbospongiosus muscle under electromyographic monitoring. Pain was evaluated by a visual analogue scale (VAS), quality of life was evaluated by the Dermatology Life Quality Index and sexual function by the Female Sexual Function Index. RESULTS: Twenty patients received the injections. Sixteen patients presented with a muscular hyperactivity on electromyography. After 3 months, 80% of the patients improved in terms of pain. Mean +/- SD VAS values significantly decreased from 8.37 +/- 1.22 (range 4.5-10) to 2.57 +/- 2.67 (0-9; P < 0.0001) at month 3 and to 3.90 +/- 2.92 (0-9; P < 0.001) at month 6. Quality of life and sexual function improved significantly during the first 6 months (P < 0.0001). After 3 months, 13 patients (out of 18 for whom intercourse was not possible before the injections; 72%) were able to have sexual intercourse. CONCLUSION: Botulinum toxin A seems to be an effective and safe treatment for provoked vestibulodynia; 100 U botulinum toxin A significantly reduced pain 3 and 6 months after injections without side-effects. The treatment also improved quality of life and sexual function of patients. Botulinum toxin A appears to be a promising option for managing sexual pain disorder.
Référence
Br J Dermatol. 2011 Mar;164(3):617-22