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Retrospective chart review of vaginal diazepam suppository use in high-tone pelvic floor dysfunction

International Urogynecology Journal volume 21, pages 895–899 (2010)Cite this article

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

  1. 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

    Article  PubMed  Google Scholar 

  2. 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

    CAS  PubMed  Google Scholar 

  3. 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

    Article  CAS  Google Scholar 

  4. 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

    Article  CAS  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. 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

    Article  CAS  PubMed  Google Scholar 

  7. 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

    Article  CAS  PubMed  Google Scholar 

  8. Rapkin AJ, Kames LD (1987) The pain management approach to chronic pelvic pain. J Reprod Med 32:323–327

    CAS  PubMed  Google Scholar 

  9. Srinivasan AK, Kaye JD, Moldwin RM (2007) Myofascial dysfunction associated with chronic pelvic floor pain: management strategies. Curr Pain Headache Rep 11:359–364

    Article  PubMed  Google Scholar 

  10. 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

    Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  Google Scholar 

  15. 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

    Article  CAS  PubMed  Google Scholar 

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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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Authors and Affiliations

  1. The Division of Urogynecology, Women and Infants’ Hospital, Warren Alpert Brown School of Medicine, 695 Eddy St., Lower Level, Suite 12, Providence, RI, 02903, USA

    Matthew J. Rogalski

  2. The Pelvic and Sexual Health Institute, Philadelphia, PA, USA

    Susan Kellogg-Spadt, Amy R. Hoffmann, Jennifer Y. Fariello & Kristene E. Whitmore

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  1. Matthew J. Rogalski
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  2. Susan Kellogg-Spadt
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  3. Amy R. Hoffmann
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  4. Jennifer Y. Fariello
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  5. Kristene E. Whitmore
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Correspondence to Matthew J. Rogalski.

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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

Keywords

  • Dyspareunia
  • High-tone pelvic floor dysfunction
  • Pelvic pain
  • Perineometry
  • Diazepam
  • AUGS 2009