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Patient acceptability of botulinum toxin injections for treatment of genito-pelvic pain/penetration disorder

Rudolph, E1

1: My Sexual Health, South Africa

Objectives: Botulinum Toxin Injections (BTI) into the external pelvic floor muscles is used in some centers as part of a multimodal treatment approach to Genito-Pelvic Pain/Penetration Disorder (GPPPD). Little is known about the patient’s perceptions of BTI as a treatment option for GPPPD. It is the aim of this survey to evaluate patient acceptability, perceived efficacy and satisfaction with BTI a treatment for GPPPD.

Material and Methods: Structured online questionnaires where sent out to fifty (50) patients who received BTI under conscious sedation as part of a multimodal treatment approach for GPPPD between March 2013 and March 2017. All received medical treatment for any underlying conditions, physiotherapy, used vaginal dilators and some received psychotherapy. BTI was only offered to those patients who did not show a satisfactory response to conservative treatment. Thirty-six (36) patients completed the questionnaires and consented to being part of this survey.

Results: The average age of the participants was 33 years (23-58). Fourteen (14) patients had been suffering from GPPPD for more than five (5) years and nineteen (19) more had been suffering for more than one year. In exactly half of the participants, sex was impossible prior to BTI. One month after BTI sex was impossible in only three (3) cases and in twenty-four (24) cases it was mildly painful to not painful at all. These numbers were unchanged at the time of the survey (more than six months post-BTI for thirty (30) participants). Nine patients were not satisfied with the effect of the BTI (25%) but only four (4) would not do it again. Only six (6) patients found the procedure of getting the BTI traumatic. Seventy-eight percent (78%) of participants found BTI to be the most valuable part of their treatment for GPPPD. It should be noted that twenty-four (24) participants (66.6%) reported a strict religious upbringing and only five (5) participants reported sexual abuse (14%).

Conclusion: The greater majority of patients perceive BTI to be an acceptable, effective and satisfactory treatment approach for GPPPD, specifically in a conservative environment like South Africa.


Work supported by industry: no.

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