Examining vaginal and vulvar health and sexual dysfunction in patients with interstitial cystitis (UNICORN-1 study)

Okui, Nobuo; Okui, Machiko; Gambacciani, Marco

doi:10.1007/s00192-022-05220-7

Cited by 11 publications

(15 citation statements)

References 36 publications

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“…However, LET resulted in mild, unsatisfactory improvement in our patient, which may be due to the severe atrophy of the vagina and vulva detected at T0. The PUF scores revealed pain levels in our patient to be worse than that generally noted in patients with IC/BPS, with the mean total PUF score previously reported as 18.19±3.52 in patients with IC/BPS and 3.76±2.35 in healthy women [3]. Similarly, our patient also had vulvodynia and poor vaginal health.…”

Section: Discussionsupporting

confidence: 46%

“…Similarly, our patient also had vulvodynia and poor vaginal health. Her VHIS score was worse than the average score of patients with IC/BPS, with the mean total VHIS score previously reported as 12.03±3.36 in patients with IC/BPS and 22.05±3.90 in healthy women in Asia [3].…”

Section: Discussionmentioning

confidence: 70%

“…Based on vulvar atrophy and poor vaginal health, the patient was diagnosed with genitourinary syndrome of menopause. The patient's Vaginal Health Index Score (VHIS) was 10 (total VHIS range: 25 (healthy) to 5 (poor)) [3,4].…”

Section: Case Presentationmentioning

confidence: 99%

“…Invasive surgical treatments include cystoscopic hydrodistension, transurethral Hunner lesion ablation, and cystectomy [1]. IC/BPS is often accompanied by vulvodynia and poor vaginal health [3,4]. Therefore, treatments for vulvodynia and poor vaginal health have been proposed for IC/BPS treatment [5].…”

Section: Introductionmentioning

confidence: 99%

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Is Erbium/Neodymium Laser Combination Therapy an Effective Treatment Option for Interstitial Cystitis/Bladder Pain Syndrome With Vulvodynia?

Okui¹,

Okui²,

Gambacciani³

2022

Cureus

Self Cite

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is often associated with vulvodynia and poor vaginal health. IC/BPS causes pelvic and bladder pain and urinary symptoms, which considerably reduce the quality of life. To date, this condition has no definitive cure. Local estrogen therapy (LET) has been proposed as a treatment for vulvodynia and poor vaginal health to improve the symptoms of IC/BPS. However, chronic LET could be contraindicated or not desired in some patients. The present study reports the case of a 55-year-old postmenopausal woman with IC/BPS who was successfully treated with combined vaginal erbium (VEL)/neodymium (Nd:YAG) laser (VEL+Nd:YAG) therapy. The patient presented with a five-year history of pelvic pain and urinary frequency. Direct approaches for the bladder (such as hydrodistension, anticholinergic drugs, and transurethral Hunner lesion ablation/cauterization) were conducted with inconsistent results. Immediately prior to the patient's presentation, LET was administered for 12 weeks; however, this therapy resulted in mild improvement and poor patient satisfaction. After presentation, VEL+Nd:YAG therapy was conducted once a month for three months. The patient reported considerable decrease in pain during urination. The improved symptoms were maintained for six months after the last therapy session. These results suggest that VEL+Nd:YAG therapy is an effective method for improving symptoms in patients with IC/BPS.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 70%

Section: Case Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is Erbium/Neodymium Laser Combination Therapy an Effective Treatment Option for Interstitial Cystitis/Bladder Pain Syndrome With Vulvodynia?

Okui¹,

Okui²,

Gambacciani³

2022

Cureus

Self Cite

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“…Recent studies have reported that women with IC/BPS show more significant sexual dysfunction, deteriorated vaginal health status, and increased vulvodynia (persistent unexplained pain in the vulva of more than three months duration) compared to healthy individuals [ 4 , 5 ]. Vulvodynia and IC/BPS often co-occur and are considered synergistic syndromes [ 4 , 5 ]. Given the limited efficacy of direct treatments for the bladder in IC/BPS women, combined treatment approaches targeting the vagina and vulva have been contemplated [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Laser Treatment for Patients With Vulvodynia and Interstitial Cystitis/Bladder Pain Syndrome: A Case Series (The UNICORN-3 Study)

Okui¹,

Okui²,

Kouno³

et al. 2023

Cureus

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Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pain disorder characterized by urgency, frequency of urination, and pelvic pain. Women with IC/BPS often experience sexual dysfunction, vulvodynia, and vaginal health issues. Combined erbium and neodymium yttrium aluminum garnet (YAG) laser treatments targeting the vagina and vulva have shown promise in improving symptoms. Our study aims to investigate the effectiveness of these combined laser treatments in women with IC/BPS and vulvodynia. Methods Women diagnosed with vulvodynia and IC/BPS underwent combined laser treatment using vaginal erbium:YAG laser (VEL) and neodymium:YAG laser (Nd:YAG). Various parameters were evaluated, including the vulvodynia test, numeric rating scale (NRS-11) for pain, interstitial cystitis symptom index and problem index (ICSI and ICPI), pelvic pain and urgency/frequency symptom score (PUF), and mean urination volume/daily urination frequency in a three-day urination diary. Treatment was administered three times, with intervals of one month between each session, and follow-up evaluations were conducted at six and 12 months. All statistical analyses were designed and programmed by the AI chatbot GPT-4 (chatGPT-4). Results Fifteen female patients diagnosed with vulvodynia and IC/BPS were treated with three sessions of VEL + Nd:YAG. Significant improvements were observed in the vulvodynia test, NRS-11 scores, PUF, ICSI scores, ICPI scores, mean urination volume, and daily urination frequency at six and 12 months (p<0.01). Short-term improvements in IC/BPS pain scores correlated with improvements in the vulvodynia test (p=0.007), suggesting a synergistic effect. However, no significant correlations were found at 12 months. Conclusion Combined laser treatments targeting the vagina and vulva showed significant therapeutic effects in women with IC/BPS and vulvodynia. The addition of Nd:YAG to the VEL treatment enhanced outcomes. Short-term improvements in IC/BPS pain scores correlated with improvements in the vulvodynia test, indicating a synergistic effect. Long-term improvements in both vulvodynia and IC/BPS symptoms may occur independently. These findings highlight the importance of comprehensive approaches for treating coexisting vulvodynia and IC/BPS.

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The association between vulvodynia and interstitial cystitis/bladder pain syndrome: A systematic review

Bosio,

Perossini,

Torella

et al. 2024

Intl J Gynecology & Obste

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BackgroundVulvodynia (VVD) is a debilitating chronic vulvar pain significantly affecting patients' quality of life. Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and complex illness characterized by an unpleasant sensation related to the filling of the bladder and it strongly impacts patients' lives. The exact mechanisms of the two syndromes remain unknown, but there is an overlap between suspected pathophysiologies.ObjectiveTo present an overview of the current research on the association between VVD and IC/BPS.Search StrategyA systematic search of three electronic databases was conducted. Studies examining the correlation between VVD and IC/BPS with male and female patients aged over 18 years were included.Selection CriteriaStudies assessing the coexistence of VVD and IC/BPS were included. Reviews, letters to the editor, conference abstracts, book chapters, guidelines, Cochrane reviews, and expert opinions were excluded.Data Collection and AnalysisTwo reviewers screened the studies for eligibility. Eligible studies were screened for quality.Main ResultsA total of 13 studies were included in the final review. Among them, 11 presented a positive association between the two syndromes. The studies highlighted that VVD and IC/BPS share common comorbidities and possibly etiopathogenic pathways.ConclusionVVD and IC/BPS are both complex and multifactorial syndromes. This review highlights an association between them, but additional studies on the topic should be conducted for a more precise conclusion.

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Examining vaginal and vulvar health and sexual dysfunction in patients with interstitial cystitis (UNICORN-1 study)

Cited by 11 publications

References 36 publications

Is Erbium/Neodymium Laser Combination Therapy an Effective Treatment Option for Interstitial Cystitis/Bladder Pain Syndrome With Vulvodynia?

Is Erbium/Neodymium Laser Combination Therapy an Effective Treatment Option for Interstitial Cystitis/Bladder Pain Syndrome With Vulvodynia?

Laser Treatment for Patients With Vulvodynia and Interstitial Cystitis/Bladder Pain Syndrome: A Case Series (The UNICORN-3 Study)

The association between vulvodynia and interstitial cystitis/bladder pain syndrome: A systematic review

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