036 Vulvar Vestibulectomy for Neuroproliferative Associated Vestibulodynia: A Retrospective Case-Control Study

King, Michelle; Mitchell, Lloyd G.; Belkin, Zoe R.; Goldstein, A.

doi:10.1016/j.jsxm.2017.04.040

Cited by 2 publications

(6 citation statements)

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“…32 Vestibulectomy was superior for CST pain in three out of five of the studies 29,32,33 and vulvar pain in one. 31 One found no difference in vulvar sensitivity. 29 CST pain was incongruent with dyspareunia in two studies.…”

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 97%

“…were the only investigators who found vestibulectomy superior to improved sexual function compared with conservative management. 31 Gungor Ugurlucan reported pain-free dilator use and improved ability to have intercourse after treatment. She also found that vestibulectomy resulted in increased frequency of intercourse in the treated individual.…”

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

“…There were five cohort studies of patients choosing surgical intervention after multimodal/interdisciplinary management compared with those who continued multimodal/interdisciplinary management. [27][28][29][31][32][33] Two incorrectly identified their studies as case-control. 31,33 There was also a single case report of a 19-year-old female unable to have sexual intercourse who underwent vestibulectomy after incomplete resolution of symptoms with physical therapy and medical management, 30 and a case series of posterior vestibulectomy after 10 weeks of physical therapy and cognitive-behavioral sex therapy consultation among 61 patients.…”

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

“…[27][28][29][31][32][33] Two incorrectly identified their studies as case-control. 31,33 There was also a single case report of a 19-year-old female unable to have sexual intercourse who underwent vestibulectomy after incomplete resolution of symptoms with physical therapy and medical management, 30 and a case series of posterior vestibulectomy after 10 weeks of physical therapy and cognitive-behavioral sex therapy consultation among 61 patients. 34 Mainly, participants choosing vestibulectomy were compared with those who chose continued multimodal/interdisciplinary management: 16 versus 50, 29 44 versus 23, 31 and 39 versus 27, 33 respectively.…”

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

“…Two studies did not report meaningful demographics. 31,32 Otherwise, participants were mainly young and nulliparous with about 5 years symptom duration, and baseline NRS pain intensity of 7-9/10. 27,29,33 The follow-up period after vestibulectomy ranged from 1 year 32 to over 3 years.…”

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

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Multimodal and Interdisciplinary Interventions for the Treatment of Localized Provoked Vulvodynia: A Scoping Review of the Literature from 2010 to 2023

Rains,

Bajzak,

Miller

et al. 2024

IJWH

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Localized provoked vulvodynia (LPV) is a chronic condition characterized by pain in the vulvar vestibule, which can be provoked by pressure or touch and which is not tied to a clear underlying cause. Research into the etiology of and most appropriate treatment strategy for LPV is still limited. Methods: Using Arksey and O'Malley's model for scoping reviews, we evaluated the research question: what is the current evidence regarding the efficacy/effectiveness of multimodal or interdisciplinary interventions for the treatment of LPV? We collated and analyzed articles from 2010 to 2023 to capture the current research landscape. Results: Our review identified 27 studies, which either compared treatments between classes (eg pharmacologic versus psychologic modalities) or described interdisciplinary treatment programs. We identify several trends in the literature. First, outcome measures are inconsistent between studies, often unvalidated, and may not adequately mirror patient concerns. Second, the absence of appropriate comparator groups in many studies restricts providers' ability to appraise which treatments may be most efficacious. Third, selection bias and demographic homogeneity limit generalizability. Finally, we highlight the need for head-to-head trials of vestibulectomy with other treatments considered first line for vulvodynia management. Conclusion: There is insufficient evidence to suggest the superiority of one treatment modality for LPV relative to others or to recommend a particular interdisciplinary management strategy. Future research should use a head-to-head design where sham control is impossible, incorporate patient-centered outcome measures, and investigate impacts of treatment among diverse samples of LPV patients.

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Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 97%

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

Section: Multimodal/interdisciplinary Management Followed By Vestibul...mentioning

confidence: 99%

See 3 more Smart Citations

Multimodal and Interdisciplinary Interventions for the Treatment of Localized Provoked Vulvodynia: A Scoping Review of the Literature from 2010 to 2023

Rains,

Bajzak,

Miller

et al. 2024

IJWH

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Vulvodynia, Genital Eczema and Lichen Sclerosus: What are the Successful Treatments from a Patient’s Perspective?

Berger,

Fierz,

Kolm

et al. 2024

IJWH

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Background Genital pain treatment regimens range from local or systemic pharmacological to non-pharmacological, manual and psychosexual therapies with poor to moderate evidence for their efficiency. The aim of this study was to evaluate the subjective therapeutic response (genital pain relief) of different treatment modalities for vulvodynia and the most prevalent other vulvar pathologies, chronic vulvar eczema and lichen sclerosus by means of a cross-sectional survey. Material and Methods A questionnaire-based cohort study that included 128 vulvodynia, 116 eczema and 79 lichen sclerosus patients was used. All patients attended the vulvar clinic at the University Hospital of Zurich. The patients who had been treated were surveyed from January to October 2022, using a customized online questionnaire consisting of 37 questions on symptoms and treatment outcomes for guideline-recommended treatment modalities. The study was approved by the Cantonal Ethics Review Board of Zurich. Results Altogether, 41 patients with vulvodynia, 37 with vulvar eczema and 23 with lichen sclerosus returned the questionnaire. The three groups were similar regarding pain characteristics and comorbidities. All three patient groups reported having benefited from non-pharmacological treatment (improvement rate vulvodynia 54%; eczema 51%; lichen sclerosus 58%), from topical (55%; 55%; 75%) and from locally invasive (46%; 66%; 50%) treatments. Overall, there was no significant difference in subjective treatment outcome between non-pharmacological, locally invasive, and topical treatments for vulvodynia, eczema, and lichen sclerosus. However, the use of oral medication was reported to be significantly less effective (p-value 0.050). Conclusion In conclusion, we found that in the patients’ perception, topical, invasive and non-pharmacological treatments, but not oral medications, are helpful for genital pain relief in women with vulvodynia, vulvar eczema, and lichen sclerosus. Therefore, we recommend an escalating therapy approach with first-line non-pharmacological treatments together with topical therapies.

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036 Vulvar Vestibulectomy for Neuroproliferative Associated Vestibulodynia: A Retrospective Case-Control Study

Cited by 2 publications

References 0 publications

Multimodal and Interdisciplinary Interventions for the Treatment of Localized Provoked Vulvodynia: A Scoping Review of the Literature from 2010 to 2023

Multimodal and Interdisciplinary Interventions for the Treatment of Localized Provoked Vulvodynia: A Scoping Review of the Literature from 2010 to 2023

Vulvodynia, Genital Eczema and Lichen Sclerosus: What are the Successful Treatments from a Patient’s Perspective?

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