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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

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Abstract

Introduction and hypothesis

Most patients suffering from vaginismus feel sinful, anxious, and incompetent, with reduced self-confidence. This study was aimed at comparing the effectiveness of the physiotherapy of pelvic floor muscles as a standard treatment and local injection of botulinum toxin on the sexual functioning of patients with primary vaginismus.

Methods

In this randomized clinical trial (RCT), the study population included women with primary vaginismus referred to the Sexual Health and Gynecologic Clinics of Imam Khomeini Hospital during 2013–2014. They were diagnosed according to DSM-5 criteria and underwent treatments with botulinum injection (intervention group) and physiotherapy as the current treatment (control group). The participants’ primary and secondary outcomes were measured based on successful intercourse and sexual functioning of each group.

Results

The results indicated that the overall standard physiotherapy, along with other measurements, such as functional electrical stimulation and desensitization, could effectively improve the patients’ Female Sexual Function Index compared with botulinum treatment. At the end of the study, it was found that 20 and 26 patients out of the 30 and 28 patients in the intervention and control groups managed to have successful intercourse respectively (P = 0.014). Also, sexual dysfunction frequencies were seen to be decreased by 26.6% and 50% in the mentioned groups respectively (p = 0.008 and p < 0.001).

Conclusions

Considering the higher efficacy of physiotherapy procedures compared with those of the desensitization and electrical stimulation techniques, this therapeutic method should be considered the first-line treatment of vaginismus (IRCT2016061828486N1).

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Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Imam Khomeini Hospital, Fellowship in Pelvic Floor Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Mansooreh Yaraghi & Tahereh Eftekhar

  2. Department of Gynecology and Obstetrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Shirin Ghazizadeh

  3. Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Fariba Mohammadi

  4. Tehran University of Medical Sciences, Tehran, Iran

    Elahe Miri Ashtiani

  5. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Mahmood Bakhtiyari

  6. Department of Gynecology and Obstetrics, Iran University of Medical Sciences, Tehran, Iran

    Sayeda Mahjabeen Mareshi

  7. Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Fatemeh Sadat Sarfjoo

Authors
  1. Mansooreh Yaraghi
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  4. Elahe Miri Ashtiani
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Corresponding author

Correspondence to Tahereh Eftekhar.

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All the procedures performed in the human participants studied were in accordance with the ethical standards of the institutional and/or national research committee(s), and with the 1964 Declaration of Helsinki and its later amendments or any other comparable ethical standards.

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Informed consent was obtained from all the individual participants included in the study.

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Yaraghi, M., Ghazizadeh, S., Mohammadi, F. et al. 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. Int Urogynecol J 30, 1821–1828 (2019). https://doi.org/10.1007/s00192-018-3836-7

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  • DOI: https://doi.org/10.1007/s00192-018-3836-7

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