Vulvodynia – an evolving disease

Abstract

Vulvodynia is a common vulval pain syndrome that occurs most commonly in reproductive women of all ages. It can, in some cases, present for the first time after menopause. Up to about 15% of adult women have had symptoms of vulvodynia, with 4–5% currently symptomatic. Since there are no specific tests for diagnosis, vulvodynia is a diagnosis of exclusion. The condition is commonly associated with other chronic pain disorders and can be exceedingly debilitating, resulting in sexual dysfunction, severe depression and/or anxiety. It can significantly impair quality of life. Goals for long-term team approach management should be discussed with the patient at the commencement of each intervention as effectiveness of therapy is not assured. Currently, there is no intervention that effects cure in all individuals and a combination of pharmacological therapy, psychotherapy and physiotherapy, reserving surgery as a last-line option, is the best option for treatment. There are no long-term data on how long women will have symptoms and, if resolved, what provokes symptoms again in the future, whilst correlation between the etiology of vulvodynia and efficacy of treatment is not known.

外阴痛——一种不断演变的疾病 摘要

外阴痛是一种常见的外阴疼痛综合征, 最常发生在各个年龄段的育龄妇女。在某些情况下, 它可以在绝经后首次出现。多达15%的成年女性有外阴痛症状, 目前有4-5%的女性有症状。由于没有专门的诊断方法, 所以外阴痛是一种排除性的诊断。这种情况通常与其他慢性疼痛障碍有关, 并可能极度衰弱, 导致性功能障碍、严重抑郁和/或焦虑。它会严重降低生活质量。在每次干预开始时, 应与患者讨论长期团队方法管理的目标, 因为治疗的有效性得不到保证。目前, 还没有对所有个体都有疗效的干预措施, 药物治疗、心理治疗和物理治疗相结合, 保守手术作为最后的选择, 这是治疗的最佳选择。目前尚无长期资料表明女性会在多长时间内消除症状, 如果消除, 什么又会引起症状复发, 而外阴痛的病因与治疗效果之间的相关性尚不清楚。

Keywords:

• Vulvodynia
• chronic vulval pain
• debilitating
• significant sexual dysfunction
• impaired quality of life
• treatment combinational
• pharmacological
• psychotherapy
• physiotherapy
• surgery last resort

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Source of funding

Nil.