Botulinum toxin-treatment of localized provoked vulvodynia refractory to conventional treatment

We wanted to evaluate the efficacy of botulinum toxin type A (botulinum toxin) treatment on vulvodynia refractory to conventional treatment.

A follow-up study on botulinum toxin treatment was conducted at Aarhus University Hospital (n = 109). Seventy-nine completed the follow-up. The women included had localized provoked vulvodynia, refractory to first line treatment and were treated with 100*I.E. botulinum toxin electromyography (EMG) guided in the musculus levator ani in the period from March 2012 to May 2015(1). The outcome measures were: Dyspareunia, Negative Interference in Quality of Life (NIQL) and cotton swab test all rated on the numerical rating scale (NRS) and active vitae sexualis. Follow-up was conducted at six months.

The women experienced significant improvements on, dyspareunia, which decreased to 5.82 from 7.82 (p < 0.01), NIQL to 6.19 from 7.88 (p < 0.01) and the cotton swab test to 5.50 from 6.81 (p < 0.01). No significant effect on Active Vitae Sexualis was found (p = 0.25).

Women injected with 100*I.E. botulinum toxin EMG guided, diagnosed with localized provoked vulvodynia refractory to conventional non invasive treatment, had a reduction in dyspareunia and improved quality of life. Injection of botulinum toxin had no significant effect on vitae sexualis. Randomized controlled trials are, however, much needed.