Abstract：
OBJECTIVE:To investigate whether botulinum neurotoxin type A improves vaginismus and study its efficacy with repeated treatments. METHODS:Outpatients were referred because standard cognitive-behavioral and medical treatment for vaginismus and vulvar vestibular syndrome failed. From this group, we prospectively recruited consecutive women (n=39) whose diagnostic electromyogram (EMG) recordings from the levator ani muscle showed hyperactivity at rest and reduced inhibition during straining. These women were followed for a mean (+/-standard deviation) of 105 (+/-50) weeks. Recruited patients underwent repeated cycles of botulinum neurotoxin type A injected into the levator ani under EMG guidance and EMG monitoring thereafter. At enrollment and 4 weeks after each cycle, women were asked about sexual intercourse; underwent EMG evaluation and examinations to grade vaginal resistance according to Lamont; and completed a visual analog scale (VAS) for pain, the Female Sexual Function Index Scale, a quality-of-life questionnaire (Short-Form 12 Health Survey), and bowel and bladder symptom assessment. RESULTS:At 4 weeks after the first botulinum neurotoxin type A cycle, the primary outcome measures (the possibility of having sexual intercourse, and levator ani EMG hyperactivity) both improved, as did the secondary outcomes, Lamont scores, VAS, Female Sexual Function Index Scales, Short-Form 12 Health Survey, and bowel-bladder symptoms. These benefits persisted through later cycles. When follow-up ended, 63.2% of the patients completely recovered from vaginismus and vulvar vestibular syndrome, 15.4% still needed reinjections (censored), and 15.4% had dropped out. CONCLUSION:Botulinum neurotoxin type A is an effective treatment option for vaginismus secondary to vulvar vestibular syndrome refractory to standard cognitive-behavioral and medical management. After patients received botulinum neurotoxin type A, their sexual activity improved and reinjections provided sustained benefits. LEVEL OF EVIDENCE:III.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Bertolasi L,Frasson E,Cappelletti JY,Vicentini S,Bordignon M,Graziottin Adoi
10.1097/AOG.0b013e3181bb0dbbsubject
Has Abstractpub_date
2009-11-01 00:00:00pages
1008-1016issue
5eissn
0029-7844issn
1873-233Xpii
00006250-200911000-00008journal_volume
114pub_type
杂志文章abstract：BACKGROUND:Cortical blindness is characterized by loss of vision in the presence of intact anterior visual pathways. Anton syndrome, a form of anosognosia, is a rare complication of cortical blindness involving compromise of the visual association centers, with resulting patient denial of blindness. Both syndromes have...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(97)00718-7
更新日期：1998-05-01 00:00:00
abstract：:Nitrous oxide analgesia was introduced into obstetrics by a young Polish-Russian physician who manufactured the gas himself, mixed it with oxygen, humidified the mixture with water vapor, and devised a mouthpiece for self-administration. After assessing the results on himself, he evaluated the effects on pain relief, ...
journal_title：Obstetrics and gynecology
pub_type： 历史文章,杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：OBJECTIVE:Over-the-counter vaginal lubricants have been shown to negatively affect in vitro sperm motility. The objective of this study was to estimate the effect of vaginal lubricant use during procreative intercourse on natural fertility. METHODS:Women aged 30-44 years with no history of infertility who had been try...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e31825b87ae
更新日期：2012-07-01 00:00:00
abstract：OBJECTIVE:To estimate rates of postpartum glucose tolerance testing in women diagnosed with gestational diabetes mellitus (GDM) and to assess factors associated with testing. METHODS:This was a retrospective cohort study of 344 women with GDM who received prenatal care in a maternal diabetes clinic during 2001-2004. R...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000245446.85868.73
更新日期：2006-12-01 00:00:00
abstract：:One hundred patients undergoing pelvic exenteration (total 69, anterior 13, posterior 18) at the University of Michigan Medical Center from 1964-1984 are reported. All patients were followed for at least 5 years or until time of death. The overall cumulative survival was 66% at 3 years and 61% at 5 years. The age of t...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1989-12-01 00:00:00
abstract：OBJECTIVE:The purposes of this prospective investigation were to determine the frequency of glove perforation during obstetric and gynecologic procedures and to assess the value of double gloving in preventing damage to the inner glove. METHODS:During a 2-month period, surgeons in the Department of Obstetrics and Gyne...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：:Nine reproductive-age women underwent removal of unilateral or bilateral dermoid cysts via laparoscopy. Over a follow-up period of 12-42 months, there were no immediate or long-term complications. Four patients have had repeat laparoscopy for evaluation of possible pelvic adhesion formation; one had mild periovarian a...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
abstract：OBJECTIVE:To study the effect of raloxifene on the response to conjugated estrogen cream or nonhormonal moisturizer in postmenopausal women with preexisting signs of vaginal atrophy. METHODS:Postmenopausal women with preexisting and untreated vaginal atrophy were enrolled in this parallel, placebo-controlled, randomiz...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0029-7844(02)02726-6
更新日期：2003-02-01 00:00:00
abstract：:A case of gonococcemia in pregnancy in which the patient presented with the classic clinical manifestations of gonococcemia--cutaneous lesions, arthritis, and possibly pericarditis--is reported. A review of the literature reveals a dramatic increase in incidence of gonorrhea and the increasing importance of the compli...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1976-10-01 00:00:00
abstract：OBJECTIVE:To evaluate the appropriateness of recommendations for hysterectomies done for nonemergency and non-oncologic indications. METHODS:We assessed the appropriateness of recommendations for hysterectomy for 497 women who had the operation between August 1993 and July 1995 in one of nine capitated medical groups ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(99)00519-0
更新日期：2000-02-01 00:00:00
abstract：:Six patients with pure nonmosaic 46,XY gonadal dysgenesis (XY GD) and histocompatibility H-Y antigen titers in the normal male range (H-Y+) are presented. Clinical characteristics included a female phenotype, masculine skeletal characteristics, signs of virilization, and primary amenorrhea. All individuals had unambig...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1981-07-01 00:00:00
abstract：:The safety of pregnancy after myocardial infarction remains a significant dilemma for both the obstetrician and the cardiologist. Only 20 cases of pregnancy after myocardial infarction have been reported. To clarify this problem, we add our experience of four such cases in which conception occurred 9 months to 9 years...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：OBJECTIVES:To ascertain the various causes of delayed postpartum hemorrhage and to test whether subinvolution of the placental bed is associated with other pregnancy disorders for which defective maternal-fetal interaction has been implicated pathogenetically. METHODS:In a group of women presenting with postpartum hem...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：BACKGROUND:Bernard-Soulier syndrome, a lack of glycoprotein IB/IX, is a rare autosomal recessive bleeding disorder characterized by platelet dysfunction. Women with Bernard-Soulier syndrome are at risk of being immunized against glycoprotein IB/IX, leading to severe isoimmune neonatal thrombocytopenia. CASE:A 26-year-...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(99)00253-7
更新日期：1999-11-01 00:00:00
abstract：:Uterine contraction pressures were quantified (in Montetevideo units) in 109 women at term gestation who received oxytocin for induction or augmentation of labor and whose labor resulted in a spontaneous vaginal delivery. Newborn five-minute Apgar scores were greater than or equal to 8 in 108 of the 109 neonates, and ...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/00006250-198609000-00003
更新日期：1986-09-01 00:00:00
abstract：:Variability of the baseline fetal heart rate is correlated with good fetal outcome, and loss of baseline variability has been observed as a sign of fetal distress. Central nervous system depressing drugs may also decrease fetal heart rate variability, and thus recognition of the effect of medication on the baseline fe...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：OBJECTIVE:To investigate the relationship between the symptom of mixed urinary incontinence and incontinence severity, urodynamic findings, and treatment response. METHODS:This is a secondary analysis of data from 553 women randomized into a double-blind, placebo-controlled study evaluating duloxetine (serotonin-norep...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0029-7844(03)00376-4
更新日期：2003-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the complications of late second-trimester abortions (18-22 weeks) by laminaria dilation and evacuation, and the obstetric outcome of subsequent pregnancies. METHODS:Dilation of the cervix was achieved by repeated laminaria tent replacement. Evacuation was carried out in the outpatient clinic usi...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0029-7844(96)00170-6
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the relationship among gestational age at elective cesarean delivery, neonatal intensive care unit (NICU) admission, and whether the presence of pre-cesarean delivery labor or ruptured membranes affected the incidence of neonatal respiratory distress. METHODS:A chart review was performed of all e...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e31816736e7
更新日期：2008-04-01 00:00:00
abstract：:: The initial visit for screening and the provision of reproductive preventive health care services and guidance should take place between the ages of 13 years and 15 years. The initial reproductive health visit provides an excellent opportunity for the obstetrician-gynecologist to start a patient-physician relationsh...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/01.AOG.0000446826.46833.c0
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:Refeeding syndrome is a rare constellation of electrolyte abnormalities after reintroduction of glucose during an adaptive state of starvation and malnutrition, resulting in fluid shifts, end-organ damage, and, potentially, death. We present a case of fetal death in a patient with hyperemesis gravidarum comp...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0000000000003276
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:To estimate the change in indications for scheduled deliveries during the Ohio Perinatal Quality Collaborative's initiative to decrease scheduled deliveries for nonmedical indications before 39 weeks of gestation. METHODS:Documented indications for scheduled deliveries between 36 0/7 and 38 6/7 weeks were ca...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e318260d9b2
更新日期：2012-08-01 00:00:00
abstract：:beta-Adrenergic agents are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the metabolic effects of intravenous infusion of ritodrine (150 to 100 microgram/min) or isoxsuprine (200 to 150 microgram/min) in a series of 28 patients with gest...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/00006250-197803000-00007
更新日期：1978-03-01 00:00:00
abstract：:Two hundred ninety-four women with cervical intraepithelial neoplasia were treated once with either cryotherapy or laser vaporization. Treatment results were controlled for grade, size, and distribution of cervical intraepithelial neoplasia. Cervical intraepithelial neoplasia measuring less than 3 cm in diameter witho...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1985-12-01 00:00:00
abstract：:Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and f...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1097/01.AOG.0000471179.25809.d8
更新日期：2015-09-01 00:00:00
abstract：:A new rapid method of presurgical cleansing of the hands has been evaluated in a clinical setting. The effectiveness of a 90 second jet wash has been compared with a standard 10-minute presurgical scrub. Bacteriologic cultures were obtained from the fingertips of interns, residents, and staff of the Department of Obst...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：OBJECTIVE:To assess whether lack of patient preparation for common physical and emotional postpartum symptoms is associated with patient satisfaction with obstetric clinicians. METHODS:We conducted a telephone survey of 724 postpartum women. Women were interviewed 2 weeks postpartum to assess self-perceived preparatio...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1097/AOG.0b013e3181c8b39b
更新日期：2010-02-01 00:00:00
abstract：:We evaluated the effect of birth order on the incidence and severity of intraventricular hemorrhage in 29 sets of very low birth weight twins (1500 g or less). Intraventricular hemorrhage occurred in 55% of first-presenting twins and 62% of second-presenting twins. The incidence of minor intraventricular hemorrhage (g...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：OBJECTIVE:To determine if oncogene overexpression in patients with advanced epithelial ovarian cancer correlates with survival. METHODS:Twenty-two women with stage III ovarian cancer, observed for a median of 66 (range 48-204) months were compared with 30 with a median survival of 18 (range 2-28) months. Using immunoc...
journal_title：Obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0029-7844(98)00121-5
更新日期：1998-07-01 00:00:00
abstract：OBJECTIVE:To evaluate a quality improvement protocol for venous thromboembolism prevention in postoperative gynecologic cancer patients. METHODS:On January 1, 2006, we initiated a universal protocol of dual prophylaxis with sequential compression devices and three times daily heparin (or daily low molecular weight hep...
journal_title：Obstetrics and gynecology
pub_type： 临床试验,杂志文章
doi：10.1097/AOG.0b013e31818b1486
更新日期：2008-11-01 00:00:00
