Vulvodynia be gone? Botox study

In this small study pain levels dropped from 8.3/10 to 1.4/10 without recurrence over the year of followup. One or two botox injection sessions were needed.

Int J Impot Res. 2006 May 18; [Epub ahead of print] Botulinum toxin A for the management of vulvodynia. Yoon H, Chung WS, Shim BS

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12875934

7 cases ” Twenty to 40 U of botulinum toxin A were used in each injection. Injection sites were the vestibule, levator ani muscle or the perineal body. Repeat injections were administered every 2 weeks if the patient’s symptoms had not fully subsided.” 5 needed one shot -two needed 2 shots;

Comment – They have got to have preselected only those subjects that had no extraneous other problems – something that’s hard to do in chronic pain. (Success in a study reminds me of the saying location-location-location – except success is preselection-preselection-preselection) Nonetheless, it shows how vulvodynia may not be all in their head. It slays me on how energy is spent on the psychological aspects of this disorder where surgically removing the vestibule in vestibulitis for example is so effective at relieving problems (without having to remove part of the patient’s brain at the same time!). :

Eur J Obstet Gynecol Reprod Biol. 2005 May 1;120(1):91-5. Modified vulvar vestibulectomy: simple and effective surgery for the treatment of vulvar vestibulitis. Lavy Y, Lev-Sagie A, Hamani Y, Zacut D, Ben-Chetrit A.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15866093

Pelvic pain treatment locally is a problem as there is no one trained specifically in that are. (please correct me if wrong). I have been sending my pateints to Dr. Magali Robert (O+G) in Calgary. I enjoyed her article on abdominal wall triggers in pelvic pain problems published here:
http://www.stacommunications.com/journals/pdfs/cme/CMEfebruary2003/pelvicpain.pdf#search=%22Magali%20Robert%20calgary%20pelvic%20pain%22

She is Program Director, Pelvic Pain Program, Calgary Health Region. They use lots of Botox there. A submission to our drug pain to cover treating pelvic pain with Botox was rejected last year.