Question thats been on my mind!

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    I have a question that’s been on my mind for quite some time about the actual procedure that Dr. Pacik does. I’ve read about the procedure and how before the Botox Dr. Pacik does an exam first (while the person is already under if I’m correct?) …what were to happen if Dr. Pacik did an internal exam and then realized that there was some other issue? For example, I have primary vaginismus and have never once had anything enter my vagina (tampons, fingers, etc) because of the instant wall/burning sensation. After I was under, and he could finally examine me, would he check to make sure there isn’t some other problem first? Like a cyst, or tumor, or hymen that’s very thick, or some other medical condition?
    I have pretty much every symptom there is that points to vaginismus, so I am 99% sure that that is what I have. I have the wall that I instantly hit when I try penetration, the burning, the anxiety. But I’ve always had this fear that it’s something entirely different that I just would never know about since I can’t have an exam done.
    I know. This all sounds like a bunch of worrying. But does anyone have these same fears or any answers as to the exam Dr. Pacik can give?


    Hi Kimberly. I, too, shared a similar worry as you. I had a laparoscopic surgery to remove an ovarian cyst well before my procedure with Dr. Pacik. Prior to the surgery, the doctor asked if he could do an examination during the surgery to make sure everything was normal as I had never had one before. I agreed as I knew I would be already under. I had always worried that it could be something other than vaginismus as I never had an exam. After surgery and the exam, he said it was a normal exam with no abnormalities and hoped that this would make it so I now could have exams going fwd. Oh, if it were that easy. He did not understand vaginismus and I left feeling embarrassed. Thank God Dr. Pacik is not like this and does understand it plus understands what each of us has gone through with it. I do not remember the exam that Dr. Pacik did at all pre-procedure as I received IV Versed in advance and, after this, next remember waking up with the dilator in place and the procedure over with. I, did, however, find some excellent posts that address this:

    Dr. Pacik writes:

    “The concern of many women with vaginismus is as you said “I will be told there is nothing wrong and I’ll be sent on my way.” Apart from a diagnosis of imperforate hymen, which requires surgery and is very rare (1 patient in 300 of my patients) my patients are treated because something is wrong. They have vaginismus which often is severe as noted by the many failed treatments. The inability to tolerate penetration is in of itself something wrong. The other common concern is that almost every patient is convinced that they will be the one failure. This too could not be further from the truth. The best approach is to look forward to the treatment which is likely to be successful and will release you from the bondage of vaginismus.”

    He further writes:

    “For patients who have high anxiety, sedation is given using IV Versed (IV Valium) before even coming into the operating room. Additional sedation is given as needed but we try to avoid too much sedation as this interferes with the cotton tipped testing to rule out vulvodynia and/or vestibulodynia. Finger exam is very gentle using topical anesthesia just to feel the spasm; no speculum is used while awake. The oxygen mask is pure O2 no funny stuff! Speculum exam, injections and progressive dilation are all done while under anesthesia. As our vets keep emphasizing there is no need to worry. The entire staff is very supportive.”

    I hope this helps and would love to hear from the other veterans regarding their experiences. Sending you hugs and support!!!


    Thank you so much for your reply! This has definitely put my mind at ease. I am definitely guilty of having the thought “I’m going to be that one person who they can’t figure out what’s wrong with me and can’t fix it with this procedure.” I’ve thought that at least 100 times. But now that I’ve stopped to think about it, I’m sure that’s something everyone thought before their procedure. Although I do have another question…what would happen if Dr. Pacik does a cotton tip test and it proves to be something like vulvodynia, does that mean the procedure wouldn’t be done/wouldn’t work? I went to the doctors about a week ago and even after relaxing as much as I could, my doctor could barely put a q-tip in more than an inch before the burning began :/ I’m nervous that it’s some problem like vulvodynia that can’t be treated with this procedure, and then I couldn’t find a cure to my problem.

    Dr. Pacik

    Hi Kimberly
    Your post is important and echoes the many concerns I hear. Vulvodynia and vestibulodynia are only rarely associated with vaginismus (less than 5 %). If you have associated conditions these will be discussed with you. Often the treatment of vaginismus helps straighten out other problems. I hope this helps.


    Ok great thank you 🙂



    I suffer from extreme anxiety, and also suffered from level 5 vaginismus. Just like you I was never able to have penetration of any sort. If I could get through this with no problem, so can you. Dr. Pacik does a quick examination by inserting a finger so that he can see if the muscle spasms are simply in the vaginal entrance or if there are more spasms further in. This was performed right before I went under anesthesia. Dr. Pacik is very gentle, and he will never do anything to hurt you. That quick exam was about two minutes and was very minor discomfort. Right after that happens you are put under, and then you wake up with this big dilator in you….and all you can think of is WOW! 🙂 you have nothing to worry about


    Thank you so much that truly is comforting to hear jessbee. Im just a huge worrier, and I keep thinking “Im going to be that one case where they find out its some big other problem that this procedure cant fix” Kinda silly really. But I cant help it haha. I hope Im wrong and that one day I’ll be able to post on here about how wrong I truly was 🙂

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