Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-29T00:08:20.168Z Has data issue: false hasContentIssue false

Chapter 29 - Vulvodynia

from Section 6 - Vulva and Vagina

Published online by Cambridge University Press:  24 November 2021

Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
Get access

Summary

Vulvodynia is a persistent, idiopathic, and multifactorial vulval pain. It presents a challenge to healthcare providers, mainly because it is a complex syndrome that requires interdisciplinary skills, especially in the neurobiological and algological fields, to avoid incorrect pathogenetic interpretations, inaccurate diagnosis and inadequate treatment.

From a neurobiological perspective, vulvodynia is a dysfunctional vulval pain caused by abnormal function of the nervous system itself, not related to a specific vulval disorder responsible for inflammatory pain, or a neural lesion responsible for neuropathic pain.

Provoked vestibulodynia is the most prevalent subtype of vulvodynia, followed by spontaneous generalized vulvodynia. The primary diagnostic goal is to determine whether the woman suffers from vulvodynia as dysfunctional pain opposed to inflammatory or neuropathic pain.

Treatment of vulvodynia requires an individually tailored and multimodal therapeutic approach, that includes counselling, psychological therapy, medical treatment, and physiotherapy. Surgery can be proposed only as a last resort in provoked vestibulodynia.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bornstein, J, Goldstein, AT, Stockdale, CK, et al. 2015 ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulval pain and vulvodynia. J Low Genit Tract Dis 2016;20:126130.CrossRefGoogle ScholarPubMed
Bornstein, J, Preti, M, Simon, JA, et al. Descriptors of vulvodynia: a multisocietal definition consensus (International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women Sexual Health, and the International Pelvic Pain Society). J Low Genit Tract Dis 2019;23:161163.Google Scholar
De Andres, J, Sanchis-Lopez, N, Asensio-Samper, JM, et al. Vulvodynia: an evidence-based literature review and proposed treatment algorithm. Pain Pract 2016;16:204236.CrossRefGoogle ScholarPubMed
Woolf, CJ. What is this thing called pain? J Clin Invest 2010;120:37423744.CrossRefGoogle ScholarPubMed
Woolf, CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain 2011;152(3 Suppl.):S2S15.CrossRefGoogle ScholarPubMed
Von Hehn, CA, Baron, R, Woolf, CJ. Deconstructing the neuropathic pain phenotype to reveal neural mechanisms. Neuron 2012;73:638652.Google Scholar
Micheletti, L, Radici, G, Lynch, PJ. Provoked vestibulodynia: inflammatory, neuropathic or dysfunctional pain? A neurobiological perspective. J Obstet Gynaecol 2014;34:285288.CrossRefGoogle ScholarPubMed
Micheletti, L, Radici, G, Lynch, PJ. Is the 2003 ISSVD terminology and classification of vulvodynia up-to-date? A neurobiological perspective. J Obstet Gynaecol 2015;35:788792.CrossRefGoogle ScholarPubMed
Haanpää, M, Attal, N, Backonja, M, et al. NeuPSIG guidelines on neuropathic pain assessment. Pain 2011;152:1427.CrossRefGoogle ScholarPubMed
Stockdale, CK, Lawson, HW. 2013 vulvodynia guideline update. J Low Genit Tract Dis 2014;18:93100.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×