Histopathologic Features of Vulvar Vestibulitis

Chadha, Sakshum; Gianotten, Woet L.; Drogendijk, A. C.; Schultz, Willibrordus Weijmar; Blindeman, L.; Meijden, WI van der

doi:10.1097/00004347-199801000-00002

Cited by 95 publications

(57 citation statements)

References 8 publications

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“…According to some authors, VVS patients have a chronic and unspecific inflammatory cell infiltrate of a mild to moderate degree in the superficial parts of the mucosa [18][19][20]. On the other hand, according to other authors, it is not possible to separate a patient from a reference subject by histological findings [21].…”

Section: Discussionmentioning

confidence: 99%

Neurochemical Characterization of the Vestibular Nerves in Women with Vulvar Vestibulitis Syndrome

Bohm‐Starke

Hilliges

Falconer

et al. 1999

Gynecol Obstet Invest

118

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Women with vulvar vestibulitis syndrome (VVS) have a distinct burning pain provoked by almost any stimuli in the area around the vaginal introitus. In a previous study we observed an increased number of intraepithelial free nerve endings in women with VVS. The aim of the present study was to neurochemically characterize the superficial nerves in the vulvar vestibular mucosa of women with VVS. Immunohistochemical methods were used to detect neuropeptides normally found in various types of nerve fibers. Calcitonin gene-related peptide, which is known to exist in nociceptive afferent nerves, was the only neuropeptide detected in the superficial nerves of the vestibular mucosa. These findings confirm our previous theory that the free nerve endings within the epithelium are nociceptors.

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Section: Discussionmentioning

confidence: 99%

Neurochemical Characterization of the Vestibular Nerves in Women with Vulvar Vestibulitis Syndrome

Bohm‐Starke

Hilliges

Falconer

et al. 1999

Gynecol Obstet Invest

118

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“…Although inflammation is frequently described in histopathological evaluation of the vestibule in these cases [12][13][14][15], controversy exists as to whether it is the cause of the vestibular sensitivity or whether vestibular inflammation is not specific and it presents in normal vestibules as well [16,17]. Most histopathological studies have reported chronic inflammation, parakeratosis and acanthosis in tissues from patients with vestibulitis [12,13,15]. In later studies, the inflammation was characterized as being composed predominantly of T lymphocytes and plasma cells with a smaller number of B lymphocytes [14] or mast cells [18].…”

Section: Introductionmentioning

confidence: 99%

Hyperinnervation and Mast Cell Activation May Be Used as Histopathologic Diagnostic Criteria for Vulvar Vestibulitis

Bornstein

Goldschmid

Sabo

2004

Gynecol Obstet Invest

170

127

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Objective: Vestibulitis is currently diagnosed based only on clinical criteria. To achieve histopathological diagnostic criteria, we carried out a computerized image analysis method. Methods: Vestibular tissues removed from 40 women with severe vestibulitis were immunostained for mast cell count and degranulation by C-kit and mast cell tryptase, respectively. Vestibular nerve cells total area was evaluated after S-100 stain. Controls were 7 women aged 18–48. The images were converted to a digital signal, and analyzed using Image Proplus V4 software. Results: We found a significant increase in inflammatory infiltrate, number of mast cells and degranulated mast cells in vestibulitis compared to normal controls. The inflammatory cells were localized around the superficial minor vestibular glands. The total nerve fiber area was ten times higher in vestibulitis patients than in controls. A significant positive correlation was found between the total nerve fiber area and the number of mast cells in the vestibulitis group of patients. Conclusion: We documented two diagnostic histopathological criteria for vestibulitis: (1) the presence of eight or more mast cells per 10 × 10 microscopic field, and (2) the total calculated area of the nerve fibers is ten times higher than expected. These findings re-establish the inflammatory nature of the vestibulitis. It is speculated that the trigger for the local outburst of nerve fibers could be related to the activation of the mast cells by a topical agent.

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“…Some studies [29][30][31] found an increase in inflammatory cells or mast cells, whereas others 32,33 found that inflammatory cell infiltrates were similar in patients with vulvodynia and control patients. More recently, vulvar biopsy specimens have shown increased neuronal proliferation and branching in the vulvar tissue of women with vulvodynia compared with tissue of asymptomatic women.…”

Section: Pathophysiologymentioning

confidence: 98%

Vulvodynia: Diagnosis and Management

Lecks¹

1998

Journal of the American Academy of Nurse Practitioners

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Histopathologic Features of Vulvar Vestibulitis

Cited by 95 publications

References 8 publications

Neurochemical Characterization of the Vestibular Nerves in Women with Vulvar Vestibulitis Syndrome

Neurochemical Characterization of the Vestibular Nerves in Women with Vulvar Vestibulitis Syndrome

Hyperinnervation and Mast Cell Activation May Be Used as Histopathologic Diagnostic Criteria for Vulvar Vestibulitis

Vulvodynia: Diagnosis and Management

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