EMG Guided Botulinum Toxin Type A Injections for Refractory High Tone Pelvic Floor Dysfunction

Inclusion Criteria: * Participant must be diagnosed with High Tone Pelvic Floor Dysfunction(HTPMFD). * Participant must have tried and failed at least one other conventional mode of therapy for HTPMFD. * Participant must be a female at least 18 years of age. * Participant must give written informed consent to participate in this study. * Participant must be able to make decisions for herself. * Participant must not be undergoing another procedure at the time of BTX A injection. Exclusion Criteria: * Participant is male. * Patient has a history of past BTX A use * Patient has had pelvic organ prolapse repair * Participant is pregnant or intends to get pregnant during the study period or is breastfeeding. * Participant is unwilling or unable (because of long distance from office) to follow-up. * Participant has a neuro-modulator device implanted. * Participant has a known bleeding disorder or is on anticoagulation. * Participant has a known hypersensitivity to BTX A. * Participant has a pre-existing neuromuscular disorder such as amytrophic lateral sclerosis, motor neuropathy, myasthenia gravis or Lambert-Eaton syndrome. * Participant with skin infection at the perineum at the site of injection.