Patterns in Vulvodynia Treatments and 6-Month Outcomes for Women Enrolled in the National Vulvodynia Registry—An Exploratory Prospective Study

Lamvu, Georgine; Alappattu, Meryl; Witzeman, Kathryn; Bishop, Mark D.; Rapkin, Andrea J.

doi:10.1016/j.jsxm.2018.03.003

Cited by 18 publications

(20 citation statements)

References 31 publications

(45 reference statements)

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“…Significant improvement or complete remission may occur, spontaneously or following treatment. [145][146][147] Signs Inspection of the vulva reveals no relevant physical findings which means that the vulva has a normal appearance or that, if a lesion is found, this lesion cannot explain the discomfort (example: a wart cannot explain diffuse burning; LS usually explains itch and not pain).…”

Section: S -Severitymentioning

confidence: 99%

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2021 European guideline for the management of vulval conditions

Meijden

Boffa

Harmsel

et al. 2022

Acad Dermatol Venereol

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Dr Lewis has received royalties for contribution to textbooks A Practical Guide to Vulval Disease. Ridley's 'The Vulva' 3 rd edition and honoraria for teaching on dermatology. She is a Council member of the European College for the Study of Vulval Disease. Professor Tiplica has received lecture honoraria from Antibiotice SA and Novartis Pharma. He is chair of IUSTI Europe and president of the Romanian Association of Dermato-Venereologists. Dr Sherrard is a Member of the European Sexually Transmitted Infections Guidelines Editorial Board; and she is an officer of the International Union against Sexually Transmitted Infections (membership secretary

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Section: S -Severitymentioning

confidence: 99%

“…Vulvodynia is a chronic pain condition having usually lasted months or years before the diagnosis is made. Significant improvement or complete remission may occur, spontaneously or following treatment 145–147 …”

Section: Clinical Featuresmentioning

confidence: 99%

2021 European guideline for the management of vulval conditions

Meijden

Boffa

Harmsel

et al. 2022

Acad Dermatol Venereol

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“…In the study by Trutnovsky et al [ 53 ], history of vulvar pain ranged from 3 months to 20 years in the surveyed patients. Lamvu et al [ 54 ] reported that the women in their study contacted a specialist around 2 years after the onset of vulvodynia symptoms.…”

Section: Discussionmentioning

confidence: 99%

Chronic Vulvar Pain and Health-Related Quality of Life in Women with Vulvodynia

Patla

Mazur-Biały

Humaj-Grysztar

et al. 2023

Life

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The aim of this study was to investigate the severity of chronic vulvar pain in women with vulvodynia and its impact on their health-related quality of life (QL). The study group consisted of 76 women aged 19 to 58. The study was carried out using the diagnostic survey method, i.e., (1) the questionnaire technique, comprising (A) the author’s questionnaire (76 questions) and (B) the WHOQOL-BREF questionnaire, and (2) the VAS. When analyzing the severity of vulvar pain on the VAS, the highest proportion of women rated it at level 6 (23.68%). This was significantly determined by certain personal characteristics (age < 25 years old) and sociodemographic characteristics (marital status: unmarried women, divorcees, widows; high school education), each at p < 0.05. Vulvodynia causes a significant deterioration (64.47%) in QL, which is mainly caused by a reduction in the ability to perform activities of daily living (27.63%) and a decrease in sexual satisfaction (27.63%). The level of stress significantly exacerbates pain (p < 0.05). The severity correlates significantly (p < 0.05) and negatively (r < 0) with QL perception, which was rated worst in the physical domain. The use of treatment resulted in a significant improvement in the physical and psychological domains (p < 0.05), and the latter was particularly influenced by physiotherapy (p < 0.05).

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“…Each qualitative pain descriptor is then rated on the 4-point pain intensity scale and added for the final score. SF-MPQ subscales have been successfully used to measure treatment responses in vulvodynia [ 32 ].…”

Section: Patients/materials and Methodsmentioning

confidence: 99%

Rationale and design of a multicenter randomized clinical trial of vestibulodynia: understanding pathophysiology and determining appropriate treatments (vestibulodynia: UPDATe)

et al. 2022

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Background Limited data are available to establish evidence-based management protocols for vestibulodynia (VBD), a chronic vulvar pain condition that affects approximately 14 million women in the U.S. For the purposes of the study, our group subdivided VBD subtypes that may benefit from different types of treatment: 1) VBD peripheral (VBD-p), characterized by pain localized to the vulvar vestibule and 2) VBD central (VBD-c), characterized by VBD alongside one or more other chronic overlapping pain conditions (e.g. irritable bowel syndrome, temporomandibular disorder, and fibromyalgia syndrome) that affect remote body regions. Here, we describe the rationale and design of an NIH-funded multicenter clinical trial comparing the effectiveness of topical and/or systemic medication for alleviating pain and normalizing pain- relevant biomarkers among women with VBD-p and VBD-c. Methods Participants will be randomly assigned to one of four parallel arms: peripheral treatment with 5% lidocaine + 0.5 mg/ml 0.02% oestradiol compound cream + oral placebo pill, 2) central treatment with the tricyclic antidepressant nortriptyline + placebo cream, 3) combined peripheral cream and central pill treatments, or 4) placebo cream and placebo pill. The treatment phase will last 16 weeks, with outcome measures and biomarkers assessed at 4 time points (0, 8, 16, and 24 weeks). First, we will compare the efficacy of treatments in alleviating pain using standardized tampon insertion with a numeric rating scale and self-reported pain on the short form McGill Pain Questionnaire. Next, we will compare the efficacy of treatments in improving perceived physical, mental, and sexual health using standardized questionnaires. Finally, we will measure cytokines and microRNAs in local vaginal and circulating blood samples using multiplex assays and RNA sequencing, and determine the ability of these biomarkers to predict treatment response. Conclusion This is the first multicenter randomized controlled trial to evaluate the efficacy of peripherally and centrally acting medications currently used in clinical practice for treating unique VBD subtypes based on distinct clinical and biological signatures. Administrative information Vestibulodynia UPDATe is a multi-centre, two-by-two factorial designed randomized, double-blind, placebo-controlled trial registered at clinical trials.gov (NCT03844412). This work is supported by the R01 HD096331 awarded to Drs. Nackley, Rapkin, Geller and Carey by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Key messages Peripheral lidocaine and oestradiol and centrally-targeted nortriptyline medications are used for the treatment of pain in women with VBD, but there is a lack of data from well-powered RCTs. This two-by-two factorial RCT will test the efficacy of these medications in VBD subtypes cha...

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Patterns in Vulvodynia Treatments and 6-Month Outcomes for Women Enrolled in the National Vulvodynia Registry—An Exploratory Prospective Study

Cited by 18 publications

References 31 publications

2021 European guideline for the management of vulval conditions

2021 European guideline for the management of vulval conditions

Chronic Vulvar Pain and Health-Related Quality of Life in Women with Vulvodynia

Rationale and design of a multicenter randomized clinical trial of vestibulodynia: understanding pathophysiology and determining appropriate treatments (vestibulodynia: UPDATe)

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