Does One Measure Fit All? The Role of Experimentally Induced Pain Tests in the Assessment of Women with Provoked Vestibular Pain

Figures & data

Figure 1 The indirect effects of experimental provoked pain on dyspareunia severity through pelvic floor hypertonicity (PFHT) at different values of the PVD subgroups. The model shows significant unstandardized regression coefficients. Dashed lines highlight non-significant relationships (p < 0.05); NS (nonsignificant indirect effect when the 95% CIs contain zero); *p < 0.05; **p < 0.01; PVD: provoked-vestibulodynia; PFHT: pelvic floor hypertonicity.

Table 1 Comparison of Vulvar Pain-Hypersensitivity Measures Between Patients and Controls

Measure	Patients (n=113)	Controls (n=43)	p
Pain evoked during vaginal intercourse (NPS 0–10)	7.87±1.71	1.00±.98	<0.001
Q-tip pain at the anterior vestibule (NPS 0–10)	2.80±2.30	0±0	<0.001
Q-tip pain at the posterior vestibule (NPS 0–10)	6.21±1.94	0.36±.73	<0.001
Pain threshold – anterior vestibule (Algesiometer, KgF)	0.35±.19	0.59±.22	<0.001
Pain threshold – posterior vestibule (Algesiometer, KgF)	0.15±.09	0.43±.19	<0.001
Tampon-test (NPS 0–10)	4.14±3.57	0.05±.0.21	<0.001
Pain evoked by muscle pressure (NPS 0–10)	5.91±2.07	0.60±.82	<0.001
Tonus level of pelvic floor muscles (none=0, mild=1, moderate=2, severe=3)	2.40±.0.68	0.58±0.95	<0.001

Abbreviation: NPS, numerical pain scale.

Table 2 Comparison of Correlations Between Dyspareunia Intensity Report and Experimentally Induced Pain Hypersensitivity Measures in Patients and Controls

	Patients (n=113)	Controls (n=43)
Q-tip anterior vestibule (NPS, 0–10)	r=0.285, p=0.003	r=000, p=1.0
Q-tip posterior vestibule (NPS, 0–10)	r=0.506, p<0.001	r=0.126, p=0.421
Algesiometer-anterior vestibule (KgF)	r=0.032, p=0.774	r=0.019, p=0.905
Algesiometer-posterior vestibule (KgF)	r=0.136, p=0.166	r=−.230, p=0.138
Muscle pain (NPS, 0–10)	r=0.406, p<0.001	r=−.060, p=0.704
Tampon-test (NPS, 0–10)	r=0.030, p=0.778	r=000, p=1.0

Note: Bold values represent significant correlation after controlling for multiple analyses.

Abbreviation: NPS, numerical pain scale.

Table 3 Correlations Between Experimentally Induced Pain Measures and Insertional Pain Intensity

	Posterior-Only Vestibulodynia		Circumferential Vestibulodynia
	Hypertonic (n=35)	Hymenal (n=37)	Hormonal (n=21)	Augmented Anterior (n=20)
Q-tip anterior vestibule (NPS, 0–10)	r=0.283, p=0.505	r=0.239, p=0.648	r=0.512, r=0.106	r=0.581, p=0.048
Q-tip posterior vestibule (NPS, 0–10)	r=0.585, p=0.003	r=0.381, p=0.128	r=.495, p=0.137	r=0.602, p=0.034
Muscle pain (NPS, 0–10)	r=.724, p<0.0001	r=.214, p.757	r=0.384, p=0.415	r=0.508, p=0.153

Note: Bold values represent significant correlation after controlling for multiple analyses.

Abbreviation: NPS, numerical pain scale.

Data Sharing Statement

The datasets analyzed for the current study are available from the corresponding author on reasonable request.