Measuring Treatment Outcomes in Women With Vulvodynia

Abstract

Vulvodynia or vulvar pain syndrome is a chronic, heterogeneous, and multifactorial gynecological condition with an estimated prevalence of 9 - 12%, broad and substantial effect on quality of life due to physical disabilities, psychological distress and sexual dysfunction. A rationale therapeutic approach for the treatment of vulvodynia is still under investigation. A review of treatment modalities proposed by most of the clinicians involved in managing these patients advocated initially utilizing non-invasive therapies and then to proceed gradually to more aggressive therapies. A multidisciplinary approach that includes behavioral science and neuroimaging is required and recommended. Additionally a team approach should be utilized to test and evaluate therapies including pelvic floor physiotheraphy, psychotherapy, microbiology and pharmacology. It is my hope that this review will assist in the understanding of vulvodynia and its measuring treatment outcomes and will provide a thrust in the right direction to once and for all clarify this complex multifactorial disorder affecting women.KeywordsTreatment; Vulvodynia; Women

Vulvodynia—An Evidence‐Based Literature Review and Proposed Treatment Algorithm

“…Vulvodynia remains a diagnosis of exclusion. Thus, excluding other treatable causes before assigning this diagnosis is imperative . Nevertheless, suspected diagnosis should be considered if: (1) woman reports superficial dyspareunia upon introital contact and clinical examination reveals Friedrich's diagnostic criteria; (2) the cotton swab test pain level by verbal reporting scale; (3)positive standardized Tampon insertion and removal test; (4) high score in numerical rating scale, daily change in pain severity (24‐hour numeric rating scale); and (5) high score in frequency of sexual intercourse (times per week) as measured on a numerical pain scale for sexual intercourse.…”

Provoked Vestibulodynia—Medical Factors and Comorbidity Associated with Treatment Outcome

“…In the literature, success rate for vestibulectomy ranges between 60%–90% as compared with 40–80% for nonsurgical interventions. However, there is no consensus regarding the definition of successful treatment outcome and methods for evaluation of outcome vary between studies as well as follow‐up time [24,27,28]. A limited number of studies investigating predictors of treatment outcome have been published.…”

Successful Therapy of Vulvodynia with Local Anesthetics: A Case Report

“…Pain scores during the last 2 years varied from 7-9 in a visual analogue scale (VAS) of 0-10 [11]. The VAS is a frequently used quantification system in patients suffering from chronic vulvodynia [12].…”