Abstract
To study intravaginal diazepam suppositories as adjunctive treatment for high-tone pelvic floor dysfunction (HTPFD) and sexual pain. A retrospective chart review was conducted on 26 patients who received diazepam suppositories as adjuvant therapy to pelvic physical therapy and intramuscular trigger point injections for bladder pain, sexual pain, and levator hypertonus. Pelvic floor muscular tone and pain were assessed by palpation and perineometry; sexual pain was objectively rated by Female Sexual Function Index (FSFI) and the Visual Analog Scale for Pain (VAS-P). Twenty-five out of 26 patients reported subjective improvement with suppository use; six out of seven sexually active patients resumed intercourse. Sexual pain as assessed on FSFI and serial VAS-P improved with diazepam (by 1.44 on 10-point scale, p = 0.14). PFM tone improved during resting (p < 0.001), squeezing (p = 0.014), and relaxation (p = 0.003) phases. Vaginal diazepam suppositories gave a clinically significant improvement in the treatment of HTPFD compared with the usual treatment regimen alone.
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References
Peters KM, Carrico DJ, Kalinowski SE, Ibrahim IA, Diokno AC (2007) Prevalence of pelvic floor dysfunction in patients with interstitial cystitis. Urology 70:16–18
Bo K, Finckenhagen HB (2001) Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and vaginal squeeze pressure. Acta Obstet Gynecol Scand 80:883–887
Peschers UM, Gingelmaier A, Jundt K, Leib B, Dimpfl T (2001) Evaluation of pelvic floor muscle strength using four different techniques. Int Urogynecol J 12:27–30
Lukban J, Whitmore K, Kellogg-Spadt S, Bologna R, Lesher A, Fletcher E (2001) The effect of manual physical therapy in patients diagnosed with interstitial cystitis, high-tone pelvic floor dysfunction, and sacroiliac joint dysfunction. Urology 57:121–122
Oyama IA, Rejba A, Lukban JC, Fletcher E, Kellogg-Spadt S, Holzberg AS et al (2004) Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction. Urology 64:862–865
Dodi G, Bogoni F, Infantino A, Pianon P, Mortellaro LM, Lise M (1986) Hot or cold in anal pain? A study of the changes in internal anal sphincter pressure profiles. Dis Colon Rectum 29:248–251
Ger GC, Wexner SD, Jorge JM, Lee E, Amaranth LA, Heymen S et al (1993) Evaluation and treatment of chronic intractable rectal pain—a frustrating endeavor. Dis Colon Rectum 36:139–145
Rapkin AJ, Kames LD (1987) The pain management approach to chronic pelvic pain. J Reprod Med 32:323–327
Srinivasan AK, Kaye JD, Moldwin RM (2007) Myofascial dysfunction associated with chronic pelvic floor pain: management strategies. Curr Pain Headache Rep 11:359–364
Mendelowitz F, Moldwin R (1997) Complementary therapies in the management of interstitial cystitis. In: Sant G (ed) Interstitial cystitis. Lippincott-Raven, Philadelphia, pp 235–239
Mathew A, Mathew MC, Thomas M, Antonisamy B (2005) The efficacy of diazepam in enhancing motor function in children with spastic cerebral palsy. J Trop Pediatr 51(2):109–113
Mitchell WG, Conry JA, Crumrine PK, Kriel RL, Cereghino JJ, Groves L, the North American Diastat Group et al (1999) An open-label study of repeated use of diazepam rectal gel (Diastat) for episodes of acute breakthrough seizures and clusters: safety, efficacy, and tolerance. Epilepsia 40:1610–1617
Hundley AW, Wu LM, Visco AG (2005) A comparison of perineometer to brink score for assessment of pelvic floor muscle strength. Am J Obstet Gynecol 192:1583–1591
Heyman S, Scarlett Y, Jones K, Ringel Y, Drossman D, Whitehead WE (2007) Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipation. Dis Colon Rectum 50:428–441
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208
Acknowledgements
We would like to acknowledge Sandy Mosiniak, CRC, for her extraordinary insight and invaluable assistance with the preparation and execution of this project.
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Rogalski, M.J., Kellogg-Spadt, S., Hoffmann, A.R. et al. Retrospective chart review of vaginal diazepam suppository use in high-tone pelvic floor dysfunction. Int Urogynecol J 21, 895–899 (2010). https://doi.org/10.1007/s00192-009-1075-7
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DOI: https://doi.org/10.1007/s00192-009-1075-7