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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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Capron D, Bensousan T, Darchis JP, Barbare JC, Butel J, Bental A, Cadranel JF, Goll A, Levy P, Ink O, Autret P, Bouraya D, Thiebaut JM, Moucheron JJ, Bernard M, Lallement PY, Delobel P. Hepatitis C virus infection risk factors in patients admitted in hospital emergency departments in Picardy. Value of oriented screening based on recommendations of the 'Direction Générale de la Santé'. Eur J Gastroenterol Hepatol 1999; 11:643-8. [PMID: 10418936 DOI: 10.1097/00042737-199906000-00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE AND DESIGN Oriented hepatitis C virus (HCV) screening on the basis of transfusion, previous or current parenteral drug addiction, invasive procedures, and in family members of patients with hepatitis C, was recommended in France by the 'Direction Générale de la Santé' (DGS). The aim of this study was to estimate the frequency of these risk factors in patients admitted in hospital emergency departments in Picardy. METHODS Between 1 June and 31 July 1996, physicians of the emergency units of seven hospitals in Picardy were asked to question admitted patients about risk factors mentioned in the DGS recommendations, and to suggest a screening test when at least one of these risk factors was present. RESULTS Among 1648 patients, 68.7% had at least one of these risk factors. Screening was accepted by 723 patients, 58.7% of those with at least one risk factor, and more than 70% of those with history of transfusion and/or drug addiction. It was immediately performed in 451, and 2.4% had anti-HCV antibodies. The prevalence of anti-HCV antibodies was 1.5% in patients without history of transfusion or drug addiction and 7.9% in those with at least one of these two risk factors. CONCLUSION Oriented screening based on transfusion or drug addiction history seems to have better efficiency than the screening policy recommended by the DGS. Poor reliability of answers about medical history was observed probably because of stress related to emergency circumstances. A screening test proposed to patients with these major risk factors by their usual physician would be probably more efficient.
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Affiliation(s)
- D Capron
- Réseau Hépatite C de Picardie, France
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Capron D, Bensousan T, Darchis JP, Barbare JC, Butel J, Bental A, Cadranel JF, Goll A, Levy P, Ink O, Autret P, Bouraya D, Thiébaut JM, Moucheron JJ, Bernard M, Lallement PY, Delobel P. [Risk factors of hepatitis C virus contamination among patients admitted at the Emergency Service of the Picardie Hospitals. Role of screening carried out according to the recommendations of the General Direction of Health]. Gastroenterol Clin Biol 1998; 22:646-7. [PMID: 9762338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Bensousan T, Garo B, Garre M, Bourbigot B, Tchoua R, Quinio P, Boles J. La numération des lymphocytes CD4 permet-elle de prévoir la survenue des pneumonies après transplantation rénale ? Med Mal Infect 1993. [DOI: 10.1016/s0399-077x(05)81012-1] [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: 10/25/2022]
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