Remote Supported Dilation Therapy

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    Hi ladies. Dr. Pacik has asked me to create a thread concerning “Remote Supported Dilation Therapy” for the treatment of vaginismus. A very good description and discussion of this can be found in the following posts:


    What do you believe works and what do you believe does not work regarding Remote Supported Dilation Therapy? What do the women who have been treated think in retrospect if this would have worked for you?


    Hi ladies. First, I’d like to sincerely congratulate all of the women who have succeeded with the internet-only counseling program. It is such a tremendous feeling and just one of the best feelings in the world to finally be free from vaginismus.

    I had the Botox treatment with Dr. Pacik in June and know that this is the only treatment that would’ve ever worked for me because I was never successful at any form of insertion prior (i.e. tampons, dilators, even a q-tip). I was a Pacik/Lamont level 5+++ and, again, could not experience any insertion without this pain/anxiety response. Following my Botox treatment, I was able to have pain-free intercourse within 1 week.

    Dr. P has written extensively on the Pacik/Lamont classification of vaginismus. Specifically, he wrote:

    ‘Grade 5 patients who have never had any form of penetration carry enormous levels of anxiety and often demonstrate extreme fear at the time of treatment. Treatment of these patients in a setting that incorporates sedation and anesthesia allows them to feel safe knowing they will not have to endure pain. Botox injections reduce the hypertonicity or spasm of the vaginal muscles while bupivacine injections and topical anesthesia allow the patient to wake up in the recovery room with a large dilator in place without discomfort. The combination of Botox and bupivacaine halts the physical pain and allows the patient to develop new emotional and mental responses both to dilation and to intercourse. The difference in behavior between the severe anxiety noted in patients with the higher grades of vaginismus pre-procedure verses their post-procedure demeanor is often profound. Tears, crying, and uncontrolled shaking pre-procedure are replaced by smiles and determination post-procedure.’

    I, again, commend and congratulate the patients that are able to do this and succeed with the remote supported dilation therapy. I think it could definitely work and the statistics have proven that it has worked for those women who have been able to have at least some form of insertion prior (i.e. tampons, dilators, etc.).

    What are your thoughts here ladies and Dr. P?


    It definitely has worked for me! I am so happy I found Dr Pacik and that he agreed to advise my via internet! Otherwise, I would still be having major problems and not being able to see a professional who understands. I felt especially able when Dr Pacik felt the confidence in me that I could do it.. and I did! I was also a Pacik/Lamont level 5, but am now able to insert the pink on a daily basis! I haven’t tried full intercourse yet, but my husband is able to penetrate!

    So, I highly recommend it and am thrilled that Dr Pacik could help me through it! 🙂

    Since then, I even feel more daring in other aspects of life.. I used to be terriffied of skiing and so many other things, but now, I feel I can do it all! We even went on a week long ski trip and people were telling me how brave I was! That hs never happened to me before!

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