5 years ago

Four-dimensional ultrasound guidance for pelvic floor Botulinum toxin A injection in chronic pelvic pain: a novel technique

Hans Peter Dietz, Jason Anthony Abbott, Erin Margaret Nesbitt-Hawes
Objectives Botulinum toxin A (BoNT-A) is used in the treatment of pelvic floor muscle overactivity associated with chronic pelvic pain (CPP) when conservative methods such as physiotherapy are not effective or appropriate. Traditional injection techniques require finger-guided palpation of pelvic floor muscles with concurrent insertion of the needle. This paper describes a novel technique for the injection of BoNT-A into the pelvic floor musculature using four-dimensional ultrasound (4D US) guidance. Methods Thirty-one BoNT-A injections were performed using the new technique between October 2013 and January 2016. Results All cases were able to be performed using 4D US guidance. Correct placement of the needle within the body of the muscle was possible in all cases. Conclusions The technique of injection of BoNT-A under 4D US guidance is feasible and allows accurate placement of toxin into the target muscle.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.17537

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