216 Vaginal Diazepam to treat Pelvic Floor Pain

Pelvic floor pain (PFP) is a common and difficult to treat problem in urologic practice. While its cause is likely multifactorial, it is theorized that increased pelvic floor musculature tone and spasm plays a major role. Diazepam is a potent muscle relaxant and its intravaginal use has been advocated in pelvic pain. We sought to review the literature on the use of transvaginal diazepam to treat high tone PFP. A literature search was performed using the keywords “vaginal,” “valium,” and “diazepam.’ Three studies were identified-- a randomized control trial by Crisp et al 2013, a prospective trial by Carrico et al 2011, and a retrospective chart review by Rogalski et al 2010. Endpoints included objective measurement of increased tone in the pelvic musculature (EMG, perineometry), vulvar pain on Q-tip exam, and levator pain on manual exam. Multiple validated and non-validated questionnaires were also used including the female sexual function index (FSFI), patient global impression of severity/improvement (PGI-S and PGI-I), visual analog scale (VAS) for pain assessment, SF 12 general health questionnaire and combined variations of the above.