Recovering from provoked vestibulodynia: Experiences from encounters with somatocognitive therapy

Danielsen, Kristine Grimen; Dahl-Michelsen, Tone; Håkonsen, Elin; Haugstad, Gro Killi

doi:10.1080/09593985.2018.1442540

Cited by 15 publications

(5 citation statements)

References 37 publications

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“…Studies focused on a single class of intervention (ie, pharmacological, psychological, and physical modalities) were separated out into multiple publications given the volume of studies and are reported elsewhere. 13 Studies of somatocognitive therapy 14,15 are described in the psychological therapies publication rather than here, as the emphasis of these interventions is on developing conscious bodily awareness and cognitive retraining to change movement and function. Somatocognitive therapy is a unique, psychologically oriented intervention delivered by a group of physiotherapists in Norway.…”

Section: Methodsmentioning

confidence: 99%

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: Methodsmentioning

confidence: 99%

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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“…In recent years, SCT has been developed to treat women with PVD [ 22 – 24 , 43 , 44 ]. SCT is a multimodal physiotherapy treatment approach previously shown to be effective in the treatment of chronic pelvic pain [ 19 – 21 ].…”

Section: Methodsmentioning

confidence: 99%

Feasibility and acceptability of somatocognitive therapy in the management of women with provoked localized vestibulodynia—ProLoVe feasibility study

Kaarbø

Danielsen

Haugstad

et al. 2022

Pilot Feasibility Stud

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Background Provoked vestibulodynia (PVD) is a prevalent chronic pain condition especially among young women. Pain is localized to the vulvar vestibule and is provoked by touch or pressure, such as penetrative intercourse. PVD can have profound consequences, adversely affecting a woman’s sexual life, relation to her partner, and her psychological health. There is an urgent need for well-designed randomized clinical trials (RCTs) to identify the most effective interventions for this neglected women’s health condition. Aims The primary aim of this study is to assess the feasibility of undertaking a full-scale RCT of somatocognitive therapy (SCT), a multimodal physiotherapy intervention, for women with PVD. The secondary aim is to evaluate the implementation and acceptability of SCT and its potential treatment effectiveness in PVD. In the full-scale RCT, SCT will be compared to standard PVD treatment. Methods A multimethod feasibility study with a single-arm before-after trial and qualitative interviews. Ten women with PVD, aged 18–33 were recruited from the Vulva Clinic at Oslo University Hospital. The intervention took place at Oslo Metropolitan University. Participants were assessed at baseline, post-treatment, and the 8-month follow-up with the tampon test and self-report questionnaires. The main feasibility outcomes were evaluation of recruitment rate, adherence to assessment tools, and follow-up rate. The participants’ experiences with the primary outcome and the intervention were explored with semi-structured interviews. Results Ten out of 18 eligible patients were recruited over 11 weeks. None were lost to follow-up. Adherence to self-report questionnaires was excellent. Adherence to tampon tests and to the reporting of treatments was good, whereas adherence to the 14-day diary was poor. No adverse events were reported. The tampon test was suboptimal as a primary outcome. SCT was found to be an acceptable treatment, based on Global Perceived Effect scores and the participants’ experiences. Conclusion The findings suggest that it is feasible to deliver a full-scale RCT of the SCT intervention for women with PVD. Some changes are suggested to optimize the protocol, such as increasing recruitment sites, change of primary outcome measures, and adding a booster session. Trial registration ClinicalTrials.govNCT04208204. Retrospectively registered on December 23, 2019.

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“…48 In Table 5, the online ACT program, 17 manual perineal rehabilitation with lidocaine 54 and somatocognitive therapy 56 showed improvements in sexuality. The qualitative study with somatocognitive therapy enabled women to develop a new relationship with their vulvas, so that this body area no longer seems distant or threatening 62 ; positive interference in sexual functioning may be related to this improvement. 63…”

Section: Sexual Functionmentioning

confidence: 99%

Individualized multidisciplinary therapy for vulvodynia

Penteado,

Bonduki,

de Araújo

et al. 2023

J of Obstet and Gynaecol

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ObjectiveThe main objective of this review was to develop strategies for individualizing multidisciplinary therapy for vulvodynia.MethodsWe conducted two literature searches; the first one focused on clinical trials assessing vulvodynia treatments published after the recommendations of the expert committee of the Fourth International Consultation on Sexual Medicine. The second search targeted studies identifying predictive factors and mediators of vulvodynia treatments, published from the earliest date to October 2022.ResultsBased on data from 55 relevant studies, we developed models of individualized multidisciplinary therapy targeting groups of women less responsive to multidisciplinary therapy (characterized by women with higher vulvar pain intensity, impaired sexual functioning, and vulvodynia secondary subtype) and to physical therapy, as an isolated treatment (characterized by women with increased pelvic floor muscle tone and vulvodynia primary subtype). Each individualized multidisciplinary therapy model comprises three components: psychotherapy, medical care, and physical therapy. These components provide distinct therapeutic modalities for distinct subgroups of women with vulvodynia; the women subgroups were identified according to the characteristics of women, the disease, partners, and relationships. Additionally, for women with provoked vestibulodynia who exhibit less benefits from vestibulectomy (such as those with higher levels of erotophobia, greater vulvar pain intensity, and the primary subtype) and encounter resistance to individualized multidisciplinary therapy, we suggest additional conservative treatments before performing vestibulectomy.ConclusionOur study is a pioneer in the development of models that allow the individualization of multidisciplinary therapy for vulvodynia and represents a significant advance in the clinical practice of gynecologists, physiotherapists, and psychologists.

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Recovering from provoked vestibulodynia: Experiences from encounters with somatocognitive therapy

Cited by 15 publications

References 37 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

Feasibility and acceptability of somatocognitive therapy in the management of women with provoked localized vestibulodynia—ProLoVe feasibility study

Individualized multidisciplinary therapy for vulvodynia

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