Strengths and Limitation :
Our study demonstrated significant improvements in PUS, dysmenorrhoea,
and deep dyspareunia in patients without co-morbidities or Convergences
PP pelvic sensitization criteria (36). The best results were obtained
when the uterine pain symptoms were isolated, with no associated pelvic
floor myofascial syndrome or co-morbidities (PBS or PVD).
In our group of patients with pelvic sensitization criteria, there was
no significant improvement in the quality of life scores, but the
Central Sensitization Inventory (CSI) (63) improved for more than half
of the patients in this group.
The results of this pilot feasibility study suggest an interesting
perspective for the treatment of severe dysmenorrhoea and PUS, in the
absence of alternative treatment, and in cases where well-conducted
medical treatments have failed.
A prospective, randomised, double-blind, multicentric study (Uteroxine)
is currently underway which compares the hysteroscopic myometrial
injection (200 IU of botulinum toxin A) to the 2mg/ml Ropivacaine
injection.
The results of the Uteroxine randomised comparative study should allow
us to confirm the benefits of botulinum toxin injections as a treatment
for this condition.