Vulvodynia

Shah, Mitul B.; Hoffstetter, Susan

doi:10.1016/j.ogc.2014.05.005

Cited by 14 publications

(12 citation statements)

References 26 publications

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“…In this test, a Cotton swab is used to gently touch areas such as the inner thigh, mons pubis, labia majora, clitoris, labia minora, Skene glands, Bartholin glands and posterior fourchette. Patients describe the light touch as painless, mild, moderate or severe pain …”

Section: Discussionmentioning

confidence: 99%

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Gynecological associated disorders and management

et al. 2019

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Background Chronic pelvic pain syndrome is complex and involves multiple organ systems. The gynecological aspects of chronic pelvic pain syndrome can be divided into four different areas: intra‐abdominal, vaginal, pelvic floor muscles and sexual pain. This article provides an overview of gynecological evaluation in patients with chronic pelvic pain and reviews the most common gynecological diagnoses and their management. Methods An extensive review of the literature including guidelines from the International Continence Society, the European Association of Urology, and the International Association for the Study of Pain was performed. Results Gynecological evaluation of patients with chronic pelvic pain begins with a thorough history and physical examination. Laboratory tests, imaging studies and diagnostic procedures can be used as adjuncts to make a diagnosis. Treatment modalities include physical therapy, medications, trigger points injections, and surgery. Conclusion Common gynecological diagnoses of chronic pelvic pain include endometriosis, adenomyosis, vulvodynia, high tone pelvic floor dysfunction, and genitopelvic pain/penetration disorder. Gynecology is one of the many systems that can be associated with chronic pelvic pain. Managing patients with chronic pelvic pain requires a multimodal and multidisciplinary approach.

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Section: Discussionmentioning

confidence: 99%

“…Patients describe the light touch as painless, mild, moderate or severe pain. 10,11 On speculum exam, any abnormal vaginal discharge should be collected and assessed by culture or wet mount analysis. Vaginal atrophy should be noted.…”

Section: Introductionmentioning

confidence: 99%

Gynecological associated disorders and management

et al. 2019

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“…For the women, this includes delay to diagnosis and impact on overall quality of life, and for the provider lack of proven strategies and evidence based guidelines for treatment. (19,20) These challenges exist, in part, because vulvodynia likely represents a spectrum of disorders, each with distinct contributors, associated factors and treatment requirements. The 2015 Consensus guidelines took a clinical step forward in recognizing the diversity of the associated factors of vulvodynia, including the presence of co-morbid conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Second, they suggest that women with PVD and FM may benefit more from early initiation of pelvic floor physical therapy (PFPT) in their treatment plan than women without FM. PFPT has been shown to improve outcomes in all women with vulvodynia and increased muscle tone (20). Third, they help us recognize the need for more research.…”

Section: Discussionmentioning

confidence: 99%

Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment

Phillips

Brown

Bachmann

et al. 2016

American Journal of Obstetrics and Gynecology

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Background Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder; both of unknown etiology. Association of these conditions is well documented. Intra-vaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps to define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these two conditions. Objective 1) correlate pain intensity during the non-genital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, 2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. Study Design Ninety-two subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (Numerical rating scale> 1) in at least 11 sites of the 18-point non-genital tender point tenderness exam. Vaginal pain sensitivity was measured using an intra-vaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm2 forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of non-genital and those of iliococcygeus regions and the posterior vaginal wall. Independent t-tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance level was at P < .05. The data were expressed as mean ± standard deviation. Results A significant correlation was found between numerical rating scale pain ratings on the non-genital tender point tenderness exam and algometer testing on the iliococcygeus region (r = 0.44, p <.0001), and the posterior vaginal wall (r = 0.45, p < .0001). Subjects with fibromyalgia by tender point tenderness, had significantly higher iliococcygeal pain (6.14 ± 2.07 vs. 3.74 ± 2.22, p = 0.0001), and posterior vaginal wall pain (5.67 ± 2.10 vs. 3.07 ± 2.16, p < 0.0001) than women without fibromyalgia by tender point tenderness. Conclusion Women with provoked vestibulodynia who experience more severe pain with nongenital tender point palpation also experience more deep vaginal pain on pelvic exam. Those who fulfill the diagnosis of fibromyalgia show significantly more intense deep vaginal pain to palpation of iliococcygeus muscles and posterior vaginal wall. Further research using a more precise definition of fibromyalgia is necessary to confirm this relationship, bu...

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“…Локализованная вульводиния подразделяется на первичную, когда боль возникает после первого проникновения во влагалище, и вторичную, возникающую спустя время [49]. Генерализованная вульводиния характеризуется локализацией болевого синдрома в области вульвы или вокруг нее, включая область лобка, больших и малых половых губ, преддверия и промежности.…”

Section: клиническая картинаunclassified