The effectiveness of Botulinum toxin on persistent pelvic pain in women with endometriosis

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Chronic pelvic pain associated with endometriosis is poorly understood. Some women with chronic pelvic pain have muscle spasm of their pelvic muscles. Muscle spasm may be a significant part of pain in women with endometriosis and other types of chronic pelvic pain. Botulinum toxin injection is widely used to treat conditions associated with excessive muscle activity and spasm. Studies of botulinum toxin injected into pelvic muscles of women with pelvic pain have shown a decrease pain and spasm, but too few women have been studied to conclude its effectiveness. We expect to show that botulinum toxin injection in women with pelvic pain will relieve some of their pelvic pain. Eligible subjects were otherwise healthy women with chronic pelvic pain and a history of endometriosis. Subjects were randomized to either botulinum toxin injection or placebo (salt water) injection. After one month, we evaluated the presence of the pain and all women were offered botulinum toxin injection. We also evaluated the need for reinjection. The purpose of this study is to determine if botulinum toxin injections into the muscles of the pelvic floor can relieve chronic pelvic pain in women with pelvic muscle spasm. We completed the study in July 2019 with all 30 subjects completing the study; data analysis is ongoing.