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Botulinum toxin, a new treatment for endometriosis-associated chronic pelvic pain? |
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Botulinum toxin, a new treatment for endometriosis-associated chronic pelvic pain?
Dr KK Aggarwal,  12 July 2019
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(NIH): According to results published in Regional Anesthesia & Pain Medicine, treating pelvic floor muscle spasm with botulinum toxin may relieve pain and improve quality of life. The study was conducted by scientists at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.

In the study, women with surgically treated endometriosis who were generally taking hormones to suppress menses, but who continued to experience pain and had pelvic floor muscle spasm, initially received injections of botulinum toxin or saline as part of a placebo-controlled clinical trial, targeting areas of spasm. At least one month after the masked study injection, 13 participants chose to receive open-label botulinum toxin injections in areas that remained in spasm and were then followed for at least four months. These patients were described in the current study at the NIH Clinical Center.

  • In all participants, during follow-up, pelvic floor muscle spasm was not detected or occurred in fewer muscles.
  • Within two months of receiving the injections, pain decreased in all of the participants, with 11 out of 13 subjects reporting that their pain was mild or had disappeared.
  • Additionally, usage of pain medication, including opioids, was reduced in more than half of the participants.
  • Prior to receiving toxin injections, eight participants reported moderate or severe disability and after treatment, six of those patients noted an improvement in disability.

These findings suggest that pelvic floor muscle spasm may be experienced by women with endometriosis and contribute to pain persisting after standard treatment. Importantly, the beneficial effects were long-lasting, with many patients reporting pain relief lasting at least six months.

 

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

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