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.