{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T03:48:23Z","timestamp":1782791303535,"version":"3.54.5"},"reference-count":41,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"09","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To comparatively evaluate the outcome of treatment with 150 versus 200 units (U) of botulinum toxin in achieving pain-free intercourse and relieving muscle contraction in order to allow gynecological examination.<\/jats:p><jats:p>\n          Methods\u2003In this comparative prospective observational study, 99 patients with vaginismus were treated with botulinum toxin injections from September 2016 to August 2021. Diagnosis and grading of vaginismus severity were assessed using a Female Sexual Function Index (FSFI) questionnaire. Under local or general anesthesia, botulinum toxin diluted with preservative-free saline (150 U and 200 U) was injected into, above, and below the right and left bulbospongiosus muscle and the lateral submucosal areas of the introitus and perineal body using an insulin syringe. Patients were recalled after 2 weeks, and the postoperative outcome was recorded using a similar preoperative questionnaire.<\/jats:p><jats:p>\n          Results\u2003Overall, the mean age of patients was 30.2 years. The baseline and clinical characteristics were comparable between the 2 groups (p\u2009&gt;\u20090.05). Significant improvements were seen in the pain and anxiety scores of finger penetration, dilator use, intercourse, and cotton swab in individual groups. The intergroup comparisons between 150 U and 200 U of Botox were not statistically significant (p\u2009&gt;\u20090.05).<\/jats:p><jats:p>\n          Conclusion\u2003Low-dose Botox (150 U) is equally effective as high dose Botox injections (200 U) in vaginismus patients. Therefore, Botox-150 U can be used to treat vaginismus as an alternative to high doses of the same substance.<\/jats:p>","DOI":"10.1055\/s-0042-1751287","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T22:58:05Z","timestamp":1657580285000},"page":"854-865","source":"Crossref","is-referenced-by-count":4,"title":["Comparative Study of 150 vs. 200 Units of Botulinum Toxin as Treatment for Vaginismus"],"prefix":"10.61622","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0524-8518","authenticated-orcid":false,"given":"Zeena R.","family":"Helmi","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, College of Medicine, Mustansiriyah University, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"47794","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1159\/000328810","article-title":"Management of female sexual pain disorders","volume":"31","author":"S C Boyer","year":"2011","journal-title":"Adv Psychosom Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1159\/000337383","article-title":"Botulinum toxin for vaginismus treatment","volume":"89","author":"J R Ferreira","year":"2012","journal-title":"Pharmacology"},{"issue":"01","key":"ref3","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s12955-021-01799-5","article-title":"The role of personal factors in quality of life among Iranian women with vaginismus: a path analysis","volume":"19","author":"A Velayati","year":"2021","journal-title":"Health Qual Life Outcomes"},{"issue":"11","key":"ref4","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1007\/s00192-018-3836-7","article-title":"Comparing the effectiveness of functional electrical stimulation via sexual cognitive\/behavioral therapy of pelvic floor muscles versus local injection of botulinum toxin on the sexual functioning of patients with primary vaginismus: a randomized clinical trial","volume":"30","author":"M Yaraghi","year":"2019","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"ref5","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders: DSM-5","author":"American Psychiatric Association","year":"2013","edition":"5th ed."},{"issue":"10","key":"ref6","doi-asserted-by":"publisher","first-page":"e10846","DOI":"10.7759\/cureus.10846","article-title":"A novel multimodal treatment method and pilot feasibility study for vaginismus: initial experience with the combination of sacral erector spinae plane block and progressive dilatation","volume":"12","author":"E P Topdagi Yilmaz","year":"2020","journal-title":"Cureus"},{"issue":"01","key":"ref8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.sxmr.2020.01.003","article-title":"Application of botulinum neurotoxin in female sexual and genitourinary dysfunction: a review of current practices","volume":"9","author":"B Dick","year":"2021","journal-title":"Sex Med Rev"},{"issue":"03","key":"ref9","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1080\/19317611.2019.1616029","article-title":"Can Botox offer help women with vaginismus? 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