Botox combined with myofascial release physical therapy as a treatment for myofascial pelvic pain

Gabriela E. Halder; Lauren Scott; Allison Wyman; Nelsi Mora; Branko Miladinovic; Renee Bassaly; Lennox Hoyte

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자료유형: 학술저널

저자정보: Gabriela E. Halder (University of South Florida) Lauren Scott (University of South Florida) Allison Wyman (University of South Florida) Nelsi Mora (University of South Florida) Branko Miladinovic (University of South Florida) Renee Bassaly (University of South Florida) Lennox Hoyte (University of South Florida)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.58 No.2

발행연도: 2017.1

수록면: 134 - 139 (6page)

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Purpose: To report the effects of combined onabotulinumtoxinA (Botox) injections and myofascial release physical therapy on myofascial pelvic pain (MFPP) by comparing pre- and posttreatment average pelvic pain scores, trigger points, and patient self-reported pelvic pain. Secondary outcomes were to examine posttreatment complications and determine demographic differences between patients with/without an improvement in pain. Materials and Methods: This was an Institutional Review Board approved retrospective case series on women over 18 years with MFPP who received Botox and physical therapy between July 2006 and November 2014. Presence of trigger points and pelvic pain scores were determined by digital palpation of the iliococcygeus, puborectalis, obturator internus, and rectus muscles. Average pelvic pain scores (0–10) reflected an average of the scores obtained from palpation of each muscle. Self-reported improvement in pain was recorded as yes/no. Results: Fifty women met the inclusion/exclusion criteria. Posttreatment, patients had lower average pelvic pain scores (3.7±4.0 vs. 6.4±1.8, p=0.005), and fewer trigger points (44% vs. 100%, p<0.001). Fifty-eight percent of patients (95% confidence interval, 44–72) noted an improvement in self-reported pain. Patients most likely to report no improvement in pain had chronic bowel disorders, while those most likely to report an improvement in pain had a history of past incontinence sling (p=0.03). Posttreatment complications included: constipation (8%), worsening urinary retention (2%), and urinary tract infection (4%). Conclusions: Botox combined with soft tissue myofascial release physical therapy under anesthesia can be effective in treating women with chronic pelvic pain secondary to MFPP.

참고문헌 (15)

참고문헌 신청

Mathias SD / 1996 / Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates / Obstet Gynecol 87:321~327

Borg-Stein J / 2002 / Focused review: myofascial pain / Arch Phys Med Rehabil 83(3 Suppl 1):S40~S47

Srinivasan AK / 2007 / Myofascial dysfunction associated with chronic pelvic floor pain: management strategies / Curr Pain Headache Rep 11:359~364

Jarvis SK / 2004 / Pilot study of botulinum toxin type A in the treatment of chronic pelvic pain associated with spasm of the levator ani muscles / Aust N Z J Obstet Gynaecol 44:46~50

Abbott JA / 2006 / Botulinum toxin type A for chronic pain and pelvic floor spasm in women: a randomized controlled trial. / Obstet Gynecol 108:915~923

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