Evidence map›Paper›PMID 42507147›Full record

ArticleInternational urogynecology journal2026

Botulinum Toxin A Injection Versus Placebo as Treatment for Chronic Pelvic Pain: Evaluating the Influence of Patients' Pretreatment Expectations.

Mahealeney Kemper, Melle A Spruijt, Wenche M Klerkx, Kim Notten, Hugo van Eijndhoven, Leonie Speksnijder, Manon H Kerkhof, Kirsten B Kuivers

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Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mahealeney KemperDepartment of Obstetrics and Gynecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegenn, The Netherlands.
Melle A SpruijtDepartment of Obstetrics and Gynecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegenn, The Netherlands. melle.spruijt@radboudumc.nl.ORCID http://orcid.org/0000-0001-6509-8270
Wenche M KlerkxDepartment of Obstetrics and Gynecology, St. Antonius Hospital, Nieuwegein, The Netherlands.ORCID http://orcid.org/0000-0002-0406-4760
Kim NottenDepartment of Obstetrics and Gynecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegenn, The Netherlands.ORCID http://orcid.org/0000-0002-9107-4974
Hugo van EijndhovenDepartment of Obstetrics and Gynecology, Isala Hospital, Zwolle, The Netherlands.ORCID http://orcid.org/0000-0001-6118-5676
Leonie SpeksnijderDepartment of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands.ORCID http://orcid.org/0000-0002-5768-7523
Manon H KerkhofDepartment of Gynecology and Reconstructive pelvic surgery, Curilion Women's Health Clinic, Haarlem, The Netherlands.ORCID http://orcid.org/0000-0001-9986-763X
Kirsten B KuiversDepartment of Obstetrics and Gynecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegenn, The Netherlands.ORCID http://orcid.org/0000-0002-4681-4304

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisChronic pelvic pain (CPP) impacts 6-27% of women aged 18-50 worldwide. To date, few studies have evaluated the influence of patients' pretreatment expectations on treatment outcomes in this population. We hypothesize that women's pretreatment expectations are associated with their perceived treatment outcomes.

methodsThis prospective cohort study included 94 women with CPP who received either botulinum toxin A or placebo injections, both combined with pelvic floor muscle therapy. Patients' expectations were assessed at baseline and at 26 weeks using questionnaires on pretreatment expectations, pelvic floor symptoms impact (PFIQ-7), health status (EQ-5D), and pain levels (VAS). Associations between expectations and outcomes were examined using multiple linear regression.

resultsMost women (78%) reported high expectations, but these were only met in one out of five women at 26 weeks follow-up. Low expectations of improvement were associated with a poorer impression of improvement at 26 weeks (p = 0.023). Women with high pretreatment expectations regarding their health status reported better EQ-5D health status scores at 26 weeks (p < 0.001). Treatment allocation did not affect expectations or outcomes. The baseline severity of symptoms of the individual questionnaires significantly influenced subsequent outcomes in the analysed questionnaires, reflecting parallel symptom trajectories.

conclusionsPatients' pretreatment expectations were associated with treatment outcomes in women with CPP. Low expectations were reflected by poorer perceived improvement at 26 weeks, providing new insights into the role of expectations in the management of CPP and trial outcomes.

Indexed as

Botulinum toxin AChronic painExpectationIntramuscular injectionPelvic floorPelvic pain

Identifiers

PMID42507147

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.