Conference Coverage

Endometriosis pain stemming from pelvic spasms improved with botulinum toxin



In another aspect of the study she also presented at the meeting, Dr. Karp, a neurologist who has studied the therapeutic use of neurotoxins such as botulinum for 30 years, showed results from an open-label extension of a randomized trial of botulinum toxin injections to treat pelvic spasm in the same cohort of women with confirmed endometriosis and confirmed pelvic muscle spasm.

Dr. Barbara Karp of the National Institute of Neurological Disorders and Stroke

Dr. Barbara Karp

The researchers looked at results for 13 women who opted for an open-label injection of 100 U of onabotulinumtoxinA (Botox) to treat pelvic spasm, after having received a double-masked, randomized injection of either the same dose of Botox or placebo. The open-label injection was at a time of the participant’s choosing, between 1 month to 1 year after the randomized injection. Pain levels and disability were high for the group as a whole.

A month after the open-label injection, spasm was reduced or absent in all subjects (P = .0005), with 11 of 13 rating pain as absent or mild (P = .0001), Dr. Karp and her colleagues reported. Between 5 and 11 months post injection, five women requested a repeat of the treatment.

Besides the data on pain and disability collected as part of the trial, Dr. Karp and her colleagues are also looking at biomarkers for pain and inflammation, and changes in medication and hormone use. They are preparing a separate literature review on injection techniques and dosages of toxin to the pelvic floor muscles.

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