Clinical Applications of Botox in the Treatment of Urogenital and Pelvic Floor Disorders
| Disorder | Treatment, IU | Location | Level of Recommendation |
|---|---|---|---|
| Urologic | |||
| Idiopathic detrusor overactivity | 100 | Bladder | A |
| Neurogenic detrusor overactivity | 200 | Bladder | A |
| Dyssynergic sphincter deficiency | 200 | Bladder | C |
| Interstitial cystitis/painful bladder syndrome | 100-200 | Bladder | C |
| Gynecologic | |||
| Pudendal neuralgia | 15-60 | Muscle | C |
| High tone pelvic floor dysfunction | 20-100 | Muscle | C |
| Vestibulodynia | 20-100 | Perineum | B |
| Colorectal | |||
| Anal fissure | 20-300 | Internal anal sphincter | B |
| Puborectalis syndrome (anismus) | 12-100 | 3 and 9 o’clock by puborectalis muscle | B |
| Hemorrhoids and healing | 20-100 | Internal anal sphincter | B |
| Anal pain | 20-200 | Muscle and/or internal anal sphincter | B |
Note: Levels of recommendation are (A) based on at least one randomized clinical trial as part of the scientific evidence and overall represents good and consistent scientific evidence; (B) methodologically correct, but nonrandomized clinical trials on the topic overall are based on limited and inconsistent scientific evidence; and (C) consensus and expert opinions or committee recommendations, but high-quality directly applicable clinical studies are lacking.