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Martial Kouame J, Levêque C, Siani C, Santos M, Delorme J, Franké O, Amiel C, Bensousan T, Thiers-Bautrant D, Bautrant E. Uterine botulinum toxin injections in severe dysmenorrhea, dyspareunia and chronic pelvic pain: Results on quality of life, pain level and medical consumption. Eur J Obstet Gynecol Reprod Biol 2023; 285:164-169. [PMID: 37127000 DOI: 10.1016/j.ejogrb.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate quality of life (Qol), pain level and medical consumption before and after uterine botulinum toxin (BT) injections in severe dysmenorrhea, dyspareunia and chronic pelvic pain. METHODS This was a before and after study using the database of a pilot study (Open-label non comparative study, on 30 patients, with severe dysmenorrhoea in therapeutic failure) assessing efficacy and cost of uterine injection of BT in women with chronic pelvic pain after failure of conventional treatment (hormonal and analgesics) (CT). Main clinical outcome: Patient Global Impression of Improvement (PGI-I), EuroQol health-related QoL (EQ-5D-5L), EuroQol-visual analogue scale (EQ-VAS), Female Sexual Function Index (FSFI), utility measure of health-related quality of life (also called health state preference values), cost and of health care consumption were collected prospectively and analysed in the two phases (before and after). The two timepoints were 12 months before uterine BT injection, when the patient had been receiving CT, and 12 months after uterine BT injection. RESULTS Median visual analogue scale scores were significantly improved by BT regarding the patients' main source of pain (31.6 vs 80.55; p < 0.00001). We also noted a significant reduction in the proportion of patients who reported dyspareunia [15 (75%) vs 3 (15%) patients, p = 0.001] and pain during menstruation (p < 0.0001). The PGI-I scale showed a significant increase in the proportion of patients who were satisfied with their treatment after receiving the BT injection. The injection of BT was frequently associated with increase in QoL and a reduction in health care consumption, and cost: 714.82 €+/- €336.43 (BT) versus 1104.16 €+/- €227.37 (CT), which could result in substantial savings approximately (389,34€) per patient. CONCLUSION This study revealed the clinical effectiveness of BT injections on dysmenorrhea, chronic pelvic pain as well as reduction of cost and health care consumption, in our population, which is innovative since no standard of treatment exists in this domain.
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Affiliation(s)
- Jean Martial Kouame
- UMR 1252 SESSTIM, INSERM, IRD/Equipe CAN-BIOS, Faculté de Pharmacie, Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13385, France.
| | - Christine Levêque
- Pelvi-Perineal Surgery and Rehabilitation Department, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France; Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Carole Siani
- UMR 1252 SESSTIM, INSERM, IRD/Equipe CAN-BIOS, Faculté de Pharmacie, Aix-Marseille Université, 27 Boulevard Jean Moulin, Marseille 13385, France
| | - Melina Santos
- Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Jessica Delorme
- Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Oona Franké
- Pelvi-Perineal Surgery and Rehabilitation Department, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France; Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Christophe Amiel
- Pelvi-Perineal Surgery and Rehabilitation Department, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France; Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Thierry Bensousan
- Pelvi-Perineal Surgery and Rehabilitation Department, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Dominique Thiers-Bautrant
- Pelvi-Perineal Surgery and Rehabilitation Department, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France; Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
| | - Eric Bautrant
- Pelvi-Perineal Surgery and Rehabilitation Department, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France; Women's Health Research Center, Medical Center L'Avancée-Clinique Axium, 31-33 Avenue du Marechal de Lattre de Tassigny, Aix en Provence 13090, France
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Levêque C, Bautrant E, Santos M, Kouame JM, Franké O, Amiel C, Bensousan T, Thiers-Bautrant D, Siani C. A Phase III, Single-Center, Randomized Controlled Trial Comparing Clinical and Cost-Effectiveness Analyses of Botulinum Toxin Uterine Injections Versus Placebo for Severe Dysmenorrhea and Chronic Pelvic Pain of Uterine Origin After Standard Therapeutic Failure. Toxicon 2022. [DOI: 10.1016/j.toxicon.2021.11.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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