Long-term assessment of effectiveness and quality of life of OnabotulinumtoxinA injections in provoked vestibulodynia

J Eur Acad Dermatol Venereol. 2016 Jan;30(1):106-11. doi: 10.1111/jdv.13437. Epub 2015 Oct 22.

Abstract

Background: Provoked vestibulodynia is a relatively common condition that affects sexual activity. Multidisciplinary care is indicated and OnabotulinumtoxinA injections are safe and effective treatment in this indication.

Aims: To assess the long-term efficacy of OnabotulinumtoxinA in provoked vestibulodynia.

Materials and methods: Twenty-one patients treated with OnabotulinumtoxinA injections (50U in each bulbospongiosus muscle) 24 months prior to the study were included. Data on pain [assessed using a visual analogue scale (VAS)], quality of life [measured by the Dermatology Life Quality Index (DLQI)] and quality of sex life [assessed using the Female Sexual Function Index (FSFI)] were collected before treatment, and 3 and 24 months after injection.

Results: Nineteen patients participated in the study and 37% had no pain after 24 months. Significant improvements were noted in the VAS, DLQI and FSFI scores between baseline and 24 months post treatment (P < 0.0001). After 24 months, 18 patients (95%) were able to have sexual intercourse. This study was open and non-controlled.

Discussion and conclusion: 100U OnabotulinumtoxinA injections constitute an effective treatment in provoked vestibulodynia with results maintained after 2 years. They significantly improve pain, and have a positive impact on patient quality of life and sex life. Beneficial effects continue in the long-term, allowing patients to resume sexual activity.

MeSH terms

  • Acetylcholine Release Inhibitors / administration & dosage
  • Acetylcholine Release Inhibitors / therapeutic use*
  • Adult
  • Botulinum Toxins, Type A / administration & dosage
  • Botulinum Toxins, Type A / therapeutic use*
  • Female
  • Humans
  • Injections
  • Pain Measurement
  • Quality of Life
  • Sexual Behavior
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vulvodynia / drug therapy*

Substances

  • Acetylcholine Release Inhibitors
  • Botulinum Toxins, Type A