Abstract
Vulvodynia is a chronic disorder in women characterized by provoked or constant vulvar pain of varying intensity without obvious abnormal clinical findings. Vulvodynia is a poorly understood, distressing and debilitating disorder. The most important controversies surrounding vulvodynia are the nomenclature and definition in the first place and second the use of surgery in its management. The management of this disorder remains insufficient and the lack of consistent terminology is confusing. Drugs effective against chronic neuropathic pain are the mainstay of treatment of classic dysesthetic vulvodynia. However, vulvar vestibulitis syndrome remains a therapeutic challenge. A pragmatic approach is recommended for the management of patients with vulvar vestibulitis syndrome. In refractory cases, vestibulectomy has a high success rate, although the evidence is mostly based on small, descriptive studies. Comparative studies of conservative versus surgical management of vulvar vestibulitis syndrome are needed.
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