In Brief:
Twenty-eight women with chronic pelvic pain and high tone pelvic floor dysfunction were recruited and enrolled in a pilot study examining the effect of electromyography (EMG) guided onabotulinum toxin A injections directly into muscle trigger points. Effect on the pelvic floor was objectively measured with a decrease in vaginal resting tone and maximal levator ani contraction. Patient perception of improvement was demonstrated with significant gains in overall quality of life measurements, specifically improvements in dyspareunia, sexual function and distress related to the pelvic floor.