Successful use of botulinum toxin type a in the treatment of refractory postoperative dyspareunia

Amy J. Park, Park AJ, Marie Fidela R. Paraiso, Paraiso MFR
Obstetrics and gynecology · 2009 · vol. 114(2) , pp. 484–487 · doi:10.1097/aog.0b013e3181998ce1 · PMID:19622971 · W2068915593
Case report OA: closed CC0 ⤵ 2 in-corpus citations
Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-24 ⓘ

Botulinum toxin type A injections into the levator ani muscles successfully treated refractory postoperative vaginismus and dyspareunia in a patient who did not respond to conservative therapies.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-22 · read from full text ⓘ

This case report describes a woman with stage 2 prolapse and defecatory dysfunction who underwent laparoscopic pelvic floor reconstruction and excision of endometriosis. Postoperatively, she developed refractory dyspareunia and de novo vaginismus that failed to respond to trigger point injections, physical therapy, and other medical or surgical interventions. The patient subsequently received botulinum toxin type A injections into her levator ani muscles, which restored sexual function for twelve months without pain recurrence. This paper is centrally about endometriosis — specifically the postoperative management of complications following the excision of endometriosis lesions.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

BACKGROUND: Refractory dyspareunia presents a challenging therapeutic dilemma. CASE: A woman with defecatory dysfunction and dyspareunia presented with stage 2 prolapse. She underwent laparoscopic and vaginal pelvic floor reconstruction with excision of endometriosis. The patient experienced increased dyspareunia and de novo vaginismus postoperatively that were refractory to trigger point injections, physical therapy, and medical and surgical management. She underwent botulinum toxin type A injections into her levator ani muscles, which allowed her to have sexual intercourse again after 2 years of apareunia with no recurrence of pain for 12 months. CONCLUSION: Injecting botulinum toxin into the levator ani muscles shows promise for postoperative patients who develop vaginismus and do not respond to conservative therapy.
Full text 969 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Background

Refractory dyspareunia presents a challenging therapeutic dilemma. CASE: A woman with defecatory dysfunction and dyspareunia presented with stage 2 prolapse. She underwent laparoscopic and vaginal pelvic floor reconstruction with excision of endometriosis. The patient experienced increased dyspareunia and de novo vaginismus postoperatively that were refractory to trigger point injections, physical therapy, and medical and surgical management. She underwent botulinum toxin type A injections into her levator ani muscles, which allowed her to have sexual intercourse again after 2 years of apareunia with no recurrence of pain for 12 months.

Conclusion

Injecting botulinum toxin into the levator ani muscles shows promise for postoperative patients who develop vaginismus and do not respond to conservative therapy.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

dyspareuniaendometriosis

MeSH descriptors

Botulinum Toxins, Type A Dyspareunia Dyspareunia Neuromuscular Agents Postoperative Complications Postoperative Complications Vaginismus Botulinum Toxins, Type A Botulinum Toxins, Type A Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Female Female Humans Humans Middle Aged Middle Aged

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cited by (1)

References (10)

Cited by (1)

Source provenance

europepmc
last seen: 2026-10-12T06:17:10.165071+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-10-08T21:06:42.330992+00:00
License: CC0 · commercial use OK