The Significance of Type A Botulinum Toxin Ten-Point Injection Therapy in the Treatment of Chronic Pelvic Pain Caused by Muscle Spasms in Women.

[INTRODUCTION AND HYPOTHESIS] This study aims to evaluate the efficacy, safety, and socioeconomic impact of botulinum toxin type A trigger point injection therapy and ten-point injection therapy for chronic pelvic pain syndrome (CPPS) caused by muscle spasm, while also exploring the efficacy and clinical significance of botulinum toxin type A ten-point injection therapy in the treatment of chronic pelvic pain.

[METHODS] This study conducted a retrospective analysis of patients hospitalized at a tertiary hospital from January 2024 to December 2024 who were diagnosed with chronic pelvic pain syndrome (CPPS) caused by pelvic floor muscle spasm. On the basis of the treatment protocol, these patients were divided into the trigger point pelvic floor muscle injection group and the ten-point injection therapy group, with data collected through follow-up visits or telephone interviews. The baseline characteristics of the two groups were compared, including age, body mass index (BMI), pain intensity (assessed using the Facial Pain Scale-Revised [FPS-R]), Short Form 12 Health Survey (SF-12), Hamilton Anxiety Rating Scale (HARS), and Overactive Bladder Symptom Score (OABSS). Propensity score matching (PSM) was used to balance significant differences in general characteristics between the two groups at a 1:1 ratio. Among the 91 patients, 44 received trigger point pelvic floor muscle injection therapy, and 47 received ten-point injection therapy. PSM successfully matched 64 patients, with 32 in each group.

[RESULTS] Among the 91 patients, 64 were successfully matched using the PSM method, divided into two groups of 32 patients each. The baseline characteristics of the patients in each group were well matched, with all showing (P > 0.05). Postoperative follow-up data indicated that both groups of patients showed a synchronous improvement trend in pain relief, anxiety improvement, and quality of life enhancement, with no statistically significant differences at any time point. This suggests that both injection methods have similar efficacy in improving clinical symptoms and quality of life in patients with chronic pelvic pain caused by muscle spasm.

[CONCLUSION] Both the ten-point injection method and trigger point injection method using type A botulinum toxin demonstrate comparable safety and efficacy in treating chronic pelvic pain caused by pelvic floor muscle spasm. However, the ten-point injection method has significant advantages in terms of not relying on trigger point localization, having a relatively fixed operational process, a shorter learning curve, less time-consuming procedures, and causing less discomfort to patients, which supports its broader clinical application.