Pelvic Floor Muscle Spasm Specialist

Recognized as a leader in the treatment of pelvic floor muscle spasm, NY Pelvic Pain and Minimally Invasive Gynecologic Surgery P.C. helps women in the greater New York, NY area understand the issues they’re experiencing with their pelvic floor muscles so they can get the most appropriate care for long-term relief.

Pelvic Floor Muscle Spasm Q & A

NY Pelvic Pain and Minimally Invasive Gynecologic Surgery P.C.


What is pelvic floor muscle spasm?

Pelvic floor muscles have two important functions. They provide physical support to the pelvic viscera and a constrictor mechanism to the anal canal, vagina and urethra. Newer imaging and physiological studies strongly suggest that these two functions of the pelvic floor are quite distinct and are likely related to different components of the pelvic floor muscles.

What problems are caused by pelvic floor muscle spasm?

When there is dysfunction or malfunction of the pelvic floor muscles the result can be dysfunction or malfunction of the critical functions provided by the pelvic floor.

  • Vaginal Problems - Namely there can be painful intercourse (dyspareunia) mainly at the entrance to the vagina. This can lead to further problems such as persistent vaginal entrance pain from the resulting neurologic hypersensitivity.
  • Urinary Problems - There can be sensations of need to urinate frequently, urgently or feelings of incomplete bladder emptying. These problems must be distinguished from a problem inside the bladder. This can easily be done with urodynamic testing and a comprehensive exam by an expert in the area. 
  • Defecatory (bowel) Problems - There can be feelings of a constant need to move the bowels and incomplete bowel emptying. There can also be a levator-sphincter dyssynergia. This is when the pelvic floor contracts to move the bowels out but the anal sphincter does not open properly.

What is the cause of pelvic floor muscle spasm?

Pelvic floor muscle spasm can be either primary (there is no underlying cause) or secondary (there is an identifiable underlying cause). When there is primary pelvic floor muscle spasm there is usually a long history of problems such as painful intercourse, urinary problems and constipation. This usually starts in the teen years but certainly may occur in younger girls.

When the pelvic floor muscle spasm is secondary it is usually due to some type of chronic inflammatory problem. The inflammation can come from repeated urinary tract infections (UTI), repeated vaginal infections such as yeast and bacterial vaginosis, or very commonly from underlying endometriosis which is a disease with a high degree of inflammation.

What are the treatment options for pelvic floor muscle spasm?

There are 2 main ways to treat pelvic floor muscle spasm.

First, physical therapy by a trained expert can work over a long period of time. This physical therapy will include internal vaginal manipulation, a well-designed home exercise program, vaginal dilators and a biofeedback program.

Often, it is recommended that patients use diazepam (vaginal suppositories) to decrease the overall muscle spasm when there is daily discomfort and/or urinary symptoms associated with the pelvic floor muscle spasm.

The second main treatment for pelvic floor muscle spasm is the use of botulinum toxin A (botox). This is the same botox that is used for muscle spasm in other parts of the body and for cosmetic purposes, except the pelvic floor muscles are very large muscles relative to the facial muscles so much higher doses are needed. 

The benefits of botox therapy are that it works quickly and lasts for a long time. Typically, fewer than 5% of patients need a repeat injection. Botox works by blocking the communication between the nerve and the muscle. Thus, it gives time for both nerve and muscle to heal from the hyperactivity. After 8-10 months have passed and the muscle tone returns to normal (or even hypertonic) the pain does not return.

Side effects of botox in the pelvic floor are uncommon (<5%), but can be associated with fecal urgency and incontinence.

Our success rate with botox therapy is approximately 95%. That means that 95% of patients will achieve greater than 75% relief.

Testimonials

Words from our patients

  • RateMDs

    "They were able to provide me everything they promised me. I've never doubted their abilities."

    Verified Patient
  • Yelp

    "The office staff was incredibly helpful with clarifying/resolving any insurance issues."

    Meg T.
  • "They take their time with you and really listen and sit down with you."

    Alyssa G.
  • Google+

    "Dr. Levey is an excellent surgeon and NY Pelvic Pain has a caring and kind staff. It is the only place to go if you need this kind of help."

    Sheila G.
  • Google+

    "The experience and knowledge in this office is beyond anything that I have had in the past. Dr. Levey took time to answer my questions even though he was busy."

    Jessi L.
  • Yelp

    "Dr. Ostrov has a great bedside manner. She is friendly, knowledgeable and easy to talk to. I feel very comfortable with her."

    Stacey F.
  • Yelp

    "I saw Dr. Nikole Ostrov, and I was incredibly impressed with how kind and non-judgmental she was."

    Ann T.
  • Yelp

    "I've been working with Dr. Davison...She is the nicest, most caring doctor I've ever had and I feel completely lucky to be under her care. "

    Danielle C.
  • Yelp

    "Dr. Davison was absolutely wonderful!! Not only was she extraordinarily pleasant and caring, but she clearly knows what she's talking about."

    Missy J.
  • Vitals

    "She is knowledgable in a no judgment way. She truly cares about the patient. If every doctor was this way medicine would be worth the price!"

    Verified Patient
  • Vitals

    "Dr. Hobbs is probably the warmest, kindest, gentlest doctor I have ever been to in my life. Wonderful experience and I know she will go extremely far!"

    Verified Patient
  • Vitals

    "Dr. Friedman performed a DNC on me last year, he and the staff at the Lenox Hill Hospital were AMAZING. They definitely make an awkward situation VERY comfortable."

    Verified Patient
Location
NY Pelvic Pain and Minimally Invasive Gynecologic Surgery P.C.
90 Maiden Lane, Suite 300
Financial District

New York, NY 10038
Phone: 646-290-9560
Fax: 212-532-4362
Office Hours

Get in touch

646-290-9560