A New Instrument for Pain Assessment in Vulvar Vestibulitis Syndrome

Abstract

Vulvar vestibulitis syndrome (VVS) is a common form of dyspareunia in premenopausal women. The standard test for diagnosing VVS is the cotton-swab test, during which a cotton-swab is applied to various locations of the vulvar vestibule. However, there is much variation in the implementation of this test relating to the precise vestibular locations palpated, the order of palpation, and the force used during palpation. We introduce a new simple, mechanical device, a vulvalgesiometer, to standardize genital pain assessment and present promising preliminary data from women with VVS and nonaffected women. These data indicate that women with VVS have significantly lower vestibular pain thresholds compared with control women. During painful vulvar stimulation with the vulvalgesiometer, women with VVS described the pain with adjectives similar to those used to describe their intercourse pain (e.g., burning). This novel device has several important implications for genital pain measurement in women who suffer from urogenital pain.

This research was supported by a Fonds pour la Formation de Chercheurs et l'Aide à la Recherche (FCAR) Fellowship to C. F. Pukall and a Canadian Institutes of Health Research (CIHR) grant to Y. M. Binik. This article stands in partial fulfillment of Ms. Pukall's Ph.D. requirements. We would like to thank Steve Kecani and Walter Kucharski for their technical expertise regarding the construction of the vulvalgesiometers and Talia Hoffstein for her assistance in collecting the data.