Re: Dyspareunia
From: Joanne Bulley, MD (islesannie@yahoo.com)
Fri Oct 28 16:30:57 2005
We have a Physical Therapist who specializes in pelvic floor dysfunction
... she has done a GREAT job with a number of my patients with pain due
to the levators / urogenital diaphragm spasm. Some of these patients
had been abused - one had some major vulvar surgery before she was
coitally active ... It has been really great to have this PT person
here and able to do this.
So before paralyzing her with BoTox - talk to your PT program. E-mail
me off list if you want and I can get you more info &/or a contact here
in Keene if your favorite PT person wants more info on PT for the pelvic
floor.
islesannie@gmail.com
Joanne
At Fri, 28 Oct 2005, Andrew Folley wrote:
>
>Sam
>I am not looking to treat her IC but I think her problem is more with
>levator ani involuntary spasm with coitus. I was looking for some choices
>for her and I know Botox has been used but seems to be expensive. andy
>
>>From: "Atkinson, Samuel M" <ATKINSONS@mail.ecu.edu>
>>Reply-To: ob-gyn-l@obgyn.net
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>Subject: RE: Dyspareunia Date: Fri, 28 Oct 2005 12:07:00 -0500
>>
>>kkClassically, hydrodistension of bladder is a treatment with varying
>>results. Obviously requires general anes. Instilling DMSO 50 is
>>another Therapy. Would suspect that the IC is the cause of Dyspareunia.
>>Have reviewed an article not yet in print on Botox for muscle spasms and
>>vulvodynia that reports +- results. Is she a horseback person riding
>>english saddle. Frank Greiss wrote an article on equestrian dyapareunis
>>in such a patient.
>>sAm
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew
>>Folley
>>Sent: Friday, October 28, 2005 10:03 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: RE: Dyspareunia
>>
>>26ye wf healthy married 3 years. Sever pain with intercourse past two
>>years. Hx of Interstitial cystitis. Pelvic not revealing minimal
>>tenderness. Husband states he feels a ridge or band 1/3 of way in
>>vagina
>>with coitus.
>>
>>Sounds like vaginismus with pelvic floor myalgia to me. I have tried
>>her on
>>neurontin with no relief. Empiric course of elmiron in light of her IC
>>no
>>relief. Any other thoughts or anecdotal treatments besides vaginal
>>dilators?
>> Some relief with Xanax berfore relations. I was hoping to be able to
>>inject something in the pelvic sidewalls? Steorids? marcaine? Botox
>>seems
>>to be good for everything?
>>andy
>>
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--
Joanne Bulley, MD
Keene, NH, USA
"Love is indescribable and unconditional.
I could tell you a thousand things that it is not, but not one that it is."
— Duke Ellington, American jazz artist (1899-1974).
