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Botulinum Toxin Treatment of Pelvic Pain Disorders. Pharmacology, Pathophysiology and Different Recommended Dosage. Meta-analysis of Clinical Botulotoxin Trials

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064211%3A_____%2F24%3AW0000026" target="_blank" >RIV/00064211:_____/24:W0000026 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11110/24:10487192 RIV/00216208:11510/24:10487192

  • Result on the web

    <a href="https://www.actualgyn.com/pdf/cz_2024_301.pdf" target="_blank" >https://www.actualgyn.com/pdf/cz_2024_301.pdf</a>

  • DOI - Digital Object Identifier

Alternative languages

  • Result language

    angličtina

  • Original language name

    Botulinum Toxin Treatment of Pelvic Pain Disorders. Pharmacology, Pathophysiology and Different Recommended Dosage. Meta-analysis of Clinical Botulotoxin Trials

  • Original language description

    The human body can experience pain or muscle spasms due to a wide range of factors. The pursuit of optimal pain management and alleviation has led to the use of botulinum toxin (BTX). Aim: To describe the characteristics and pathophysiology of BTX. The efficacy of BTX was assessed through a meta- analysis of clinical trials employing placebo controls. Due to the unavailability of controlled trials on the vulvo-perineal area, we opted to replace them with controlled trials conducted on striated muscles in various human body regions. We assume that the biochemical reaction is either identical or very similar. This paper outlines our proposed recommendations regarding applications in the vulvo-perineal region, including the corresponding dosage. Methods and Patients: A review of clinical trials pertaining to BTX was performed. Databases from 2000 to 2023 were evaluated. No placebo-controlled studies were conducted specifically on the muscles of the vulvo-perineal area. Nine trials of patients with muscle spasticity after stroke fulfilled the criteria. Patients were treated with BTX A Botox or Dysport. The assessment of muscle spasticity change involved calculating the mean difference of the Modified Ashworth Scale (MAS) before and 4-6 weeks post-treatment. Cohen's d was employed to indicate the effect size. The overall study's effect size was 0.97; P<.001, indicating a large effect size of the meta-analysis. Homogeneity was not distorted, P = 0.076. Heterogeneity implies slight distortion, I-2 = 46%. The forest plot confirms this finding. The Funnel Plot encompasses a wide range of studies, suggesting consistent findings and limited bias. The dosage of BTX pertains to the fact that commonly used Botox and Dysport have a calculation ratio of 1 IU to 2.5 IU. A Botox dosage <= 400 units is considered safe, with an odds ratio (OR) of 0.97 without a notable rise in adverse events (AEs); a dosage of >600 units has an OR of 2.98, accompanied by a notable increase in AEs. The Botox dosage for the vulvo-perineal area is approximately 100 IU divided into several punctures. After one month, a booster dose is available. Discussion: We summarized the fundamental physiopathology of BTX and demonstrated its efficacy in mitigating pain and spastic pain among patients. We presented a suitable dosage of BTX in the vulvo-perineal area and discussed potential dosage limitations.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30214 - Obstetrics and gynaecology

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2024

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    AKTUALNI GYNEKOLOGIE A PORODNICTVI

  • ISSN

    1803-9588

  • e-ISSN

  • Volume of the periodical

    16

  • Issue of the periodical within the volume

    2024-10-24

  • Country of publishing house

    CZ - CZECH REPUBLIC

  • Number of pages

    7

  • Pages from-to

    80-86

  • UT code for WoS article

    001343332900001

  • EID of the result in the Scopus database