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A Functional Approach to Gynecologic Pain
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Localized vulvar pain syndrome has previously been referred to by a number of different names, including vulvodynia, vestibulodynia, and vulvar vestibulitis. Consensus panels have recommended a functional approach to this nomenclature: (a) vulvar pain caused by a specific disorder; and (b) vulvodynia (persistent vulvar pain without an identifiable etiology).74
Sexual Emergencies: A Psychiatrist's Perspective
Published in R. Thara, Lakshmi Vijayakumar, Emergencies in Psychiatry in Low- and Middle-Income Countries, 2017
T.S. Sathyanarayana Rao, Gurvinder Kalra
This is a syndrome of unexplained vulvar pain that is frequently associated with physical disabilities, limitation of daily activities, sexual dysfunction, and psychological issues (Friedrich 1987). Although it starts off as an acute problem, it may soon become chronic, lasting for months to years. According to patients, the pain is of a burning nature (McKay 1989). In the absence of any physical or laboratory findings, cases of vulvodynia may be referred to a psychiatrist (Ashman and Ott 1989). Treatment with tricyclic medications has proved successful in some patients.
Benign conditions of the vulva and vagina, psychosexual disorders and female genital mutilation
Published in Helen Bickerstaff, Louise C Kenny, Gynaecology, 2017
Vulvodynia is the condition of pain on the vulva most often described as a burning pain, occurring in the absence of skin disease or infection. It is akin to a neuropathic pain syndrome. The pain can be further classified by the anatomical site (e.g. generalized, localized or clitoral) and also by whether pain is provoked or unprovoked. Vulvodynia can occur at any age, and causes huge distress to sufferers. It is essential to exclude physical causes such as dermatitis. The Vulval Pain Society can be an invaluable source of information and support for sufferers. There is recent evidence that neuromodulators are of limited benefit in vulvodynia but some women find them useful (particularly if pain inhibits sleep, when a sedative neuromodulator such as amitrytiline can be used).
Pharmacological Treatments for Localized Provoked Vulvodynia: A Scoping Review
Published in International Journal of Sexual Health, 2023
Krisztina Bajzak, Alex Rains, Lisa Bishop, Michelle Swab, Michelle E. Miller, Gabrielle S. Logan, Victoria Jackman, Liam Jackman, Diana L. Gustafson
Vulvodynia is a complex chronic pain condition characterized by vulvar pain lasting at least three months without a clear, identifiable cause (Bornstein et al., 2016). New vulvodynia cases are estimated to occur in 4.2 per 100 people yearly (Reed et al., 2014), and prevalence is estimated to range from 4 to 16% (Eppsteiner et al., 2014). Vulvodynia may be localized (a portion of the vulva) or generalized (the entire vulva) and may be provoked by pressure or touch or occur spontaneously. Whether specific classifications may be linked to distinct etiologies or predict response to treatment is still uncertain. Given this uncertainty, and the fact that localized provoked vulvodynia (LPV) is the most common form of vulvodynia (Harlow et al., 2014), this review solely addresses treatments for this subtype.
Diagnosis and treatment of pudendal and inferior cluneal nerve entrapment syndrome: a narrative review
Published in Acta Chirurgica Belgica, 2022
Katleen Jottard, Pierre Bonnet, Viviane Thill, Stephane Ploteau, Stefan de Wachter
In the perineal pararectal approach described by Shafik, a vertical incision is made between the anus and the ischial tuberosity. The inferior rectal nerve serves as a landmark for identification of the PN at the level of the Alcock’s canal, which is opened up to the ischial spine [26]. Eleven patients, diagnosed with idiopathic vulvodynia, were included in his study. They all had a positive response to a PNB and surgery was performed bilaterally. The vulvar pain improved gradually and disappeared in nine out of eleven patients. Perineal EMG and PN terminal motor latency (PNTML) scores were also improved in those nine patients. No postoperative complications occurred. Unfortunately, this approach only gives access to the Alcock’s canal, which is only one of many sites of possible nerve entrapment.
Vulvodynia – an evolving disease
Published in Climacteric, 2022
The updated definition proposed two categories for persistent vulvar pain:Vulvar pain caused by a specific disorder, the most important being infections, of which recurrent candidiasis is most common; inflammatory, especially lichen sclerosis and lichen planus; trauma, from obstetric history; neurologic, following pudendal nerve compression or injury; and neoplasia or hormonal deficiencies, following menopause.Vulvodynia — ‘Vulval discomfort, most often described as burning pain occurring in the absence of relevant physical findings or a specific clinically identifiable neurologic disorder’ of at least 3-month duration, and further subcategorized intolocalized or generalized;provoked, spontaneous or both;primary or secondary onset;temporal pattern (intermittent, persistent, constant, immediate);delayed pain.