Pro's and Con's of Botox

Botox options, which Doctors use this form of treatment and techniques offered.

Re: Pro's and Con's of Botox

Postby Tiegarlillie » Fri Jul 13, 2012 11:54 pm

I too am evaluating Botox with Hibner. My problem seems different than the majority of his patients. I have pain at the vaginal entrance. My exam with Lisa showed nothin visably abnormal. MRI also shows nothing. Saw Loretta who said I have severe pelvic floor spasms that MAY be causing the pain. This does not interfere with my dIly functioning but does however affect my sex life tremendously.This finding caught me off guard because I do not have abdominal pain and Lisa said she felt no spasms on her exam. I am all for the pudendal block as this procedure carries the least amount of risks. Loretta thought Botox would help, so I said sure.
After reading this forum it makes me question my choice. I know that Hibner is an amazing surgeon who is working hard to establish research and spread awareness of pelvic pain disorders. I get Botox done cosmetically and love it. It makes me feel like this should be safe.
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Re: Pro's and Con's of Botox

Postby deBBieW » Sat Jul 14, 2012 5:10 am

Hi tiegarlillie,
[quote]I too am evaluating Botox with Hibner. My problem seems different than the majority of his patients. I have pain at the vaginal entrance. My exam with Lisa showed nothin visably abnormal. MRI also shows nothing. Saw Loretta who said I have severe pelvic floor spasms that MAY be causing the pain. This does not interfere with my dIly functioning but does however affect my sex life tremendously.This finding caught me off guard because I do not have abdominal pain and Lisa said she felt no spasms on her exam.[quote]

So are you saying Lisa felt no spasm and yet on the same visit Loretta did? I wonder how their findings can be so different?
Did Hibner evaluate/examine you?

Has he had other women with similar issues?

Debbie
Vag pain, leg burning 3/11, SIJ inj 7/11, Pelvic PT, Chiro/acupuncture,
2-CT pudendal blks 11/2012, did help, less deep vag pain
Potter MRI 04/2012 - Scar tissue/thickening at SS/ST, scar in Alcock canal -bilateral,
Hibner 6/12 suggests Botox (didnt do), 8/12 more pelvic PT w/ dry needling
Gabapentin 1800 mg, Lyrica 200 mg, 5mg valium, vicodin as needed
Trying to get rid of central sensitization burning pain in my legs, Valium seems to be helping
Looking into more mindfulness options. . . . .
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Re: Pro's and Con's of Botox

Postby Tiegarlillie » Sat Jul 14, 2012 5:53 am

I saw Lisa on day one and Hibner and Loretta the next day. Hibner did not examine me as he has full confidence in Loretta's judgement of pelvic floor tension. I can speak from working with surgeons on a daily basis. Dr. Hibner may not be as great at exams because he is a surgeon, he cuts and repairs, etc.Loretta has worked with women for over ten years withnpelvic floor tension. He feels that her evaluation is better than his would be. He knows internal anatomy very well, external exams and palpation is more challenging for a surgeon. I know better than making him examine me. I have seen another vulvovaginal specialist in Phoenix. Afer over a year of different treatments, Dr Brooks wanted to do a vestibulectomy which I was Leary about. That is how I ended up in Hibners office. I happen to live in Phoenix, so I feel lucky to have access to these two.
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Re: Pro's and Con's of Botox

Postby Dr. Jason G. Attaman » Sun Jan 11, 2015 11:43 pm

There is statistically very little risk with botox injection. It is used in very high doses in children with spasticity from cerebal palsy or brain injuries, and even then serious side effects are extremely rare. Every TV personality or actor you see on TV has had botox injected MANY times for their wrinkles.

Typically either it works for your issue or it does not. Very rarely the pain will get worse.
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Re: Pro's and Con's of Botox

Postby ezer » Thu Jan 15, 2015 6:00 am

I disagree with you. I had insane pain for 20 days after (guided) Botox injections. It was significantly worse than the pain I experienced after pudendal decompression surgery .

A week after Botox injections, I had blood work done in preparation for my physical. A few days later, I got a call from my GP saying that my test was quite abnormal. I redid the blood test 3 months later and everything was normal again.

I am not the only patient that suffered terribly after Botox injections for pelvic pain. I was contacted by several patients after I posted about it and a friend of mine had a very similar reaction.
2002 PN pain started following a fall on a wet marble floor
2004 Headache in the pelvis clinic. Diagnosed with PNE by Drs. Jerome Weiss, Stephen Mann, and Rodney Anderson
2004-2007 PT, Botox, diagnosed with PNE by Dr. Sheldon Jordan
2010 MRN and 3T MRI showing PNE. Diagnosed with PNE by Dr. Aaron Filler. 2 failed PNE surgeries.
2011-2012 Horrific PN pain.
2013 Experimented with various Mind-body modalities
3/2014 Significantly better
11/2014 Cured. No pain whatsoever since
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Re: Pro's and Con's of Botox

Postby Dr. Jason G. Attaman » Fri Jan 16, 2015 1:06 am

ezer wrote:I disagree with you. I had insane pain for 20 days after (guided) Botox injections. It was significantly worse than the pain I experienced after pudendal decompression surgery .

A week after Botox injections, I had blood work done in preparation for my physical. A few days later, I got a call from my GP saying that my test was quite abnormal. I redid the blood test 3 months later and everything was normal again.

I am not the only patient that suffered terribly after Botox injections for pelvic pain. I was contacted by several patients after I posted about it and a friend of mine had a very similar reaction.


Wow, I'm sorry you had such a bad reaction!

Admittedly, any medical procedure can at times be painful for some, though they may be non painful for the majority of patients.

Important to keep in mind that such reactions to botox therapy are extremely rare based on the medical literature.

Botox does not have any effect on routine blood work such as is taken for an annual physical exam based on the medical literature. I used to care for children and adults receiving botox in VERY large doses on an inpatient setting (large rehabilitation hospital), and even with daily comprehensive laboratory work, we never saw any laboratory abnormalities attributed to botox therapy. I would not want people to think botox therapy is a common cause of lab abnormalities.
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Re: Pro's and Con's of Botox

Postby ezer » Sun Jan 18, 2015 6:39 pm

I went to see my PT 10 days after the Botox incident. For what its worth, my PT examined me and found out that the 3 muscles injected (obturator, levator, and adductor) had released as expected but that the slack had been taken by other muscles that were spasming (and were fine before the injections). She theorized that it must have stretched/squeezed the pudendal nerve in new ways.
2002 PN pain started following a fall on a wet marble floor
2004 Headache in the pelvis clinic. Diagnosed with PNE by Drs. Jerome Weiss, Stephen Mann, and Rodney Anderson
2004-2007 PT, Botox, diagnosed with PNE by Dr. Sheldon Jordan
2010 MRN and 3T MRI showing PNE. Diagnosed with PNE by Dr. Aaron Filler. 2 failed PNE surgeries.
2011-2012 Horrific PN pain.
2013 Experimented with various Mind-body modalities
3/2014 Significantly better
11/2014 Cured. No pain whatsoever since
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Re: Pro's and Con's of Botox

Postby Dr. Jason G. Attaman » Sun Jan 18, 2015 8:53 pm

ezer wrote:I went to see my PT 10 days after the Botox incident. For what its worth, my PT examined me and found out that the 3 muscles injected (obturator, levator, and adductor) had released as expected but that the slack had been taken by other muscles that were spasming (and were fine before the injections). She theorized that it must have stretched/squeezed the pudendal nerve in new ways.


That is really interesting and I can see that happening. The pelvic floor is so complex with such an elaborate interplay of muscles that this situation would not surprise me. One dance partner takes a break and the others jump in just to make things difficult!
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