Abstract
Aim: This case report aims to present our experience with intra-vaginal injections for the treatment of primary vaginismus. Methods: The patient underwent intra-vaginal injections of Botox and insertion of a dilator under anesthesia with follow up progressive dilation. Results: The patient experienced complete resolution of vaginismus and pain-free intercourse within 10 days of the procedure. Conclusion: Intra-vaginal Botox injections with progressive dilation should be considered for treatment of primary vaginismus.
Highlights
We describe a patient with primary vaginismus who achieved resolution with the injection of Botox and insertion of a dilator under anesthesia with follow-up progressive dilation
The Botox procedure is not indicated as treatment for vulvodynia; some patients experience resolution of vulvodynia once their vaginismus is successfully treated by Botox [11]
The patient is informed that Botox takes effect in two to five days and consistent, progressive dilation can assist with relieving discomfort
Summary
We describe a patient with primary vaginismus who achieved resolution with the injection of Botox and insertion of a dilator under anesthesia with follow-up progressive dilation. Botox loses its effectiveness within 4-6 months, a second Botox procedure is usually not needed if the patient has made the transition from post-operative dilation to intercourse during this time period. A medical practitioner and sexuality counselor work together to determine the level of anxiety, fear, and/or pain surrounding vaginal penetration in order to provide the patient with the best treatment options.
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