Morrissey, D, et al. Botulism Toxin A Injections Into Pelvic floor Muscles Under Electromyographic Guidance for Women with Refractory High-tone Pelvic Floor Dysfunction: A 6-Month Prospective Pilot Study.

 

Female pelvic med and reconstruct surg 2015, March 18 Epub ahead of print
Additional article for discussion

July 8, 2015 Pelvic PT Distance Journal Club

Jane Franczak

Objective: to examine the efficacy of EMG guided botox for pain and increased QoL for high tone pelvic floor dysfunction (HTPFD).

OnabotulinumtoxinA ( botox) is a neurotoxin which inhibits the release of acetylcholine and leads to ms paralysis. May last 3-6 months. Guidance from EMG can lead to precise location of high tone or TPs to ensure accurate delivery and lead to improved QoL.

A pilot randomized trial of levator injections versus physical therapy for treatment of pelvic floor myalgia and sexual pain

Zoorob, D. et al,

Int Urogynecol J (2015) 26:845-852. 

Question investigated: Are PT and Levator Trigger point Injections (LTPI comparable as treatment for improving chronic pain and sexual function (PFM Pelvic floor myalgia )?

Materials and methods: ramdomized trial btw a course of vaginal injections of triamcinolone and bupivacaine vs. pelvic floor PT for treatment of PFM.

Patients: chosen by 1 of 2 MDs, with self-reported pelvic pain and evidence of MTPs in pelvic floor ( PR, PC, IC, C and OI). No prior pelvic rehab or LTPI .Randomized to either group.

Aged 18+, sexually active, pain with intercourse, Excluded if: pregnant, used aspirin within a week of study, hx untreated pelvic absess, cardiac arrhythmia,  bladder pain syndrome, current pelvic rehab or LTPI.

The Relationship Between Incontinence, Breathing Disorders, Gastrointestinal Symptoms,

Michelle D. Smith, PhD,* Anne Russell, MMedStat,w and Paul W. Hodges, PhD

Clin J Pain, Vol 30 (2), Feb 2014, 162-7.

July 8, 2015 Pelvic PT Distance Journal Club

Jane Franczak

Summary:

Question asked: Does the presence of 1 disorder increased the risk for another?

Current data suggests/assumes causal pathway from resp. disorder,  incontinence, and GI leads to back pain ,

But it IS POSSIBLE that BP may contribute to development of other disorders.