Botulinum toxin to treat pelvic pain.

Botulinum toxin's (BoNT) success in treating several pain disorders has triggered interest in its application for pelvic pain disorders. This article summarizes results presented at the recent Neurotoxins Meeting in Madrid, Spain, in January 2017. It does not include BoNT use for Interstitial Cystitis/Bladder Pain Syndrome, which was the topic of a separate lecture. It includes studies documenting the beneficial effects of OnaBoNTA for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men using both transrectal and transurethral injection techniques. It also focuses on research using OnaBoNTA to treat levator spasms in women with chronic pelvic pain. Finally, it presents a novel approach using high density quantitative surface EMG to map out innervation zones and allow for more precise targeting of hypertonic pelvic floor muscles.