Anesthesia is used routinely during the treatment of vaginismus with the Botox program.
Why anesthesia for vaginismus treatment?
There tends to be considerable fear and anxiety to penetration because of the history of severe pain with attempted penetration. More severe vaginismus patients have often tried many different treatment programs only to fail again and again. Many of these women are unable to make any progress with dilators and have considerable fear that dilation is part of the treatment program. Typically these women avoid pelvic touch. For most of the patients it would be impossible to approach the pelvic area with a needle. Cooperation is simply not possible.
Apart from the injections I have found that progressive dilation while under anesthesia allows me to stretch the area using progressively larger dilators that would not be possible without anesthesia. This makes it possible for patients to rapidly advance with their own dilation. The anesthetic also allows me to release a constricting hymen when this too causes difficulty with penetration. About 10% of patients are noted to have this problem during examination. A small snip on either side is all that is needed. Bleeding is minimal.
What type of anesthetic is used?
Patients are given conscious sedation which allows them to breathe on their own yet be able to sleep and be unaware of treatment. General anesthesia is not 
used, this is reserved for major surgical cases. Conscious sedation allows me to do the injections and progressively dilate the vagina with no pain. Generally the patient is asleep for only about 15 to 20 minutes and wakes up rapidly when the treatment has been completed. The sedation is similar to what is used for colonoscopy.
What can be done to prevent anesthesia nausea?
Some patients get an upset stomach from anesthetic drugs. Just let us know ahead of time and we will place a scopolamine patch behind your ear to help with this.
How long does it take to recover from the conscious sedation?
Generally one to a few minutes. Patients wake up quickly. A long acting local anesthesia (bupivacaine) will have been injected making the entire vagina numb so that you can wake up with no pain. This also allows you to work with the dilators during your recovery without pain.
Risks and safety of anesthesia for vaginismus
This type of sedation is used worldwide for procedures that require minimal anesthesia. Conscious sedation has a high level of safety.
What are the outcomes of treatment?
Several studies have been done by Dr. Pacik which show a success rate over 90%. Only rarely does a patient need to return for repeat injections. Scientific articles about vaginismus will help you understand the science behind vaginismus treatment.
It can be helpful to educate your doctor about vaginismus. If your doctor would like to better understand vaginismus and vaginismus treatment, a recent paper by Dr. Peter T. Pacik, “Clinical Opinion: Understanding and Treating Vaginismus: A Multimodal Approach”, can be downloaded from our webpage Vaginismus Publications.
Summary
Conscious sedation is a form of anesthesia which allows the patient to breathe on her own yet be asleep during the treatment. Vaginismus treatment is made much easier this way. Long term safety using this approach has been published.
Read more about the Botox multimodal program.
Contact us
Begin your vaginismus journey today by contacting us. We offer a free review of your questionnaires and a complimentary phone call by Dr. Pacik once the forms have been reviewed.
