Botox for pelvic pain and overactive bladder

Dr Erin Nesbitt-Hawes

Botox has been utilised in the treatment of women with chronic pelvic pain and associated pelvic floor muscle overactivity since 1997.  Following initial case reports and a pilot study, a randomised controlled trial was performed demonstrating an improvement in vaginal pressures measured by perineometry, as well as some types of pain (specifically dyspareunia and non-menstrual pelvic pain). It is likely the Botox acts in a number of ways to improve pain related to pelvic floor muscle spasm including a direct effect of muscle relaxation, combined with a reduction in local inflammation, and central and peripheral nervous system effects are all likely contributors to reductions in pain.

Similarly, Botox has been used in the treatment of overactive bladder, with detrusor muscle relaxation and a reduction in symptoms.

This presentation will outline the mechanisms of action and evidence for Botox in the treatment of these conditions.


Dr Erin Nesbitt-Hawes is an Obstetrician and Gynaecologist with a special interest in laparoscopic surgery and endometriosis.  She has completed an Australian Gynaecological Endoscopy Society (AGES) accredited laparoscopic surgery at the Royal Hospital for Women in Randwick.  She is currently a director of Alana Healthcare for Women and staff specialist at the Royal Hospital for Women.  Erin has a strong interest in clinical research and completed her PhD at UNSW in the application of three and four-dimensional ultrasound of the pelvic floor for women with pelvic pain.  She is a conjoint lecturer at UNSW and enjoys teaching and training medical students and junior doctors.  Erin has many publications in the field of gynaecology and has presented at both national and international conferences. Recently her work was awarded the Royal Australian College of Obstetricians and Gynaecologists Clinical Fellow’s Research Scholarship.