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

Andrés, José De; Sanchis-Lopez, Nerea; Asensio-Samper, Juan Marcos; Fabregat-Cid, Gustavo; Villanueva-Pérez, Vicente L.; Dolz, Vicente Monsalve; Mínguez, A.

doi:10.1111/papr.12274

Cited by 76 publications

(65 citation statements)

References 184 publications

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“…Individualized treatments for VD are generally considered the best option based on the Vulvodynia guideline [17] and multidisciplinary approach is recommended based on a systematic review [18]. The results of our study are in line with previous data concerning multimodal treatments.…”

Section: Discussionsupporting

confidence: 81%

Vulvodynia—Younger Age and Combined Therapies Associate With Significant Reduction in Self-Reported Pain

Aalto

Vuoristo

Tuomaala

et al. 2017

J Low Genit Tract Dis

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Correspondent: Anu Aalto, anu.aalto@hotmail.com, tel.+358 40 55232953 Précis: Combination of treatments is the most effective option for vulvodynia patients in terms of pain reduction. 4 AbstractObjectives: 8 % of women suffer from vulvodynia (VD), a chronic pain disorder with unknown etiology. Aims of our study were to assess the efficacy of given VD treatments measured by numerical self-reported pain score (NRS) and patients' quality of life.Methods: Study material consisted of a retrospective VD patient cohort (n=70). Data was collected by postal questionnaires and review of the medical records.Results: We report here a statistically significant reduction in NRS only with combination of therapies (median NRS before treatments 8 vs. median NRS 4 after treatments, p<0.001) but not with any individual therapy alone i.e. physiotherapy, topical medications, oral pharmaceutical therapy, sexual counseling by a trained nurse, sacral neuromodulation, laser treatment or surgery. Older age (>30) and frequent (≥6) outpatient clinic visits associated with a significantly minor reduction in NRS (p=0.03 and p=0.04, respectively).Conclusions: The results of this retrospective study suggest, that an effective, multimodality-based treatment is most beneficial for VD patients, and VD at older age may represent a subtype more resistant to therapy.

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Section: Discussionsupporting

confidence: 81%

Vulvodynia—Younger Age and Combined Therapies Associate With Significant Reduction in Self-Reported Pain

Aalto

Vuoristo

Tuomaala

et al. 2017

J Low Genit Tract Dis

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“…Gabapentin and other anticonvulsants (e.g., lamotrigine, carbamazepine) influence neural ion conduction and neurotransmitter release and can decrease neuropathic pain [75]. Additionally, lidocaine, acetaminophen, dextromethorphan, opioid analgesics, and tramadol can also provide neuropathic pain relief [73,78]. Topical therapy may include lidocaine [83], capsaicin [84], amitriptyline, and baclofen.…”

Section: Vulvar Pain Disordersmentioning

confidence: 98%

“…Inflammation also plays a central role in vulvodynia, caused by trauma of the vestibular mucosa, which leads to peripheral and central sensitization [78]. Infections, such as those with Candida albicans, may perpetuate an immunological response increasing the risk of vulvodynia [79].…”

Section: Vulvar Pain Disordersmentioning

confidence: 99%

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

Shah

Ginzburg

Morrissey

et al. 2015

Curr Bladder Dysfunct Rep

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The diagnosis and treatment of chronic pelvic pain have shifted from organ-specific to multifactorial, multidisciplinary, and individualized approach. While many organizations have had diverse outlooks on classification and treatment plans, new research has identified varied clinical phenotypes and updated classification systems. These phenotypes are based on pain, gender, symptomatology, and comorbid pain syndromes. These new classification systems allow a multimodal therapeutic approach and evaluation of patients. Multidisciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy, and pain medicine, is also further recognized for adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies.

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“…Tricyclic antidepressant (amitriptyline), and anticonvulsants such as gabapentin have been used to treat vulvodynia . In one study, women taking amitriptyline were more likely to have pain improvement compared to those who were not .…”

Section: Diagnosis and Managementmentioning

confidence: 99%

“…Lifestyle modifications includes weight loss, appropriate amount of sleep and exercise, management of mood disorders and other medical co‐morbidities . Dietary modification such as low oxalate diet or avoidance of certain acidic foods (coffee, alcohol, tomatoes and spices) can help reduce symptoms associated with vulvodynia and IC/BPS, thus decreasing the pain associated with sexual dysfunction …”

Section: Diagnosis and Managementmentioning

confidence: 99%

Gynecological associated disorders and management

et al. 2019

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Background Chronic pelvic pain syndrome is complex and involves multiple organ systems. The gynecological aspects of chronic pelvic pain syndrome can be divided into four different areas: intra‐abdominal, vaginal, pelvic floor muscles and sexual pain. This article provides an overview of gynecological evaluation in patients with chronic pelvic pain and reviews the most common gynecological diagnoses and their management. Methods An extensive review of the literature including guidelines from the International Continence Society, the European Association of Urology, and the International Association for the Study of Pain was performed. Results Gynecological evaluation of patients with chronic pelvic pain begins with a thorough history and physical examination. Laboratory tests, imaging studies and diagnostic procedures can be used as adjuncts to make a diagnosis. Treatment modalities include physical therapy, medications, trigger points injections, and surgery. Conclusion Common gynecological diagnoses of chronic pelvic pain include endometriosis, adenomyosis, vulvodynia, high tone pelvic floor dysfunction, and genitopelvic pain/penetration disorder. Gynecology is one of the many systems that can be associated with chronic pelvic pain. Managing patients with chronic pelvic pain requires a multimodal and multidisciplinary approach.

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

Cited by 76 publications

References 184 publications

Vulvodynia—Younger Age and Combined Therapies Associate With Significant Reduction in Self-Reported Pain

Vulvodynia—Younger Age and Combined Therapies Associate With Significant Reduction in Self-Reported Pain

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

Gynecological associated disorders and management

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