Document Detail

Vulvar vestibulitis syndrome: an often unrecognized cause of dyspareunia.
MedLine Citation:
PMID:  10099756     Owner:  NLM     Status:  MEDLINE    
Vulvar vestibulitis syndrome (VVS) is an easily identifiable cause of entry dyspareunia. The aetiology is unknown although there is a strong association with Candida infection. The condition represents a focal area of hyperaesthesia within the vulvar vestibule. A management protocol for patients with this condition is presented; 230 patients with VVS were managed and followed-up over a 5-year period. Spontaneous resolution or improvement occurred in 21% of patients following initial explanation and use of simple local measures. In 21%, there were positive Candida cultures and long-term antifungal therapy resulted in a 71% cure. In Candida-negative patients, low-dose amitriptyline was used (up to 75 mg daily) with a 60% positive response rate. Carbamazepine was of little benefit (13% response). Surgical vestibulectomy was offered when conservative measures failed and this was performed in 22 patients (10%) with a beneficial result in 20 patients (91%).
R Pagano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  39     ISSN:  0004-8666     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-05-20     Completed Date:  1999-05-20     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  79-83     Citation Subset:  IM    
Vulvar Disorders Clinic, Royal Women's Hospital, Melbourne, Victoria.
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MeSH Terms
Amitriptyline / therapeutic use
Analgesics, Non-Narcotic / therapeutic use
Antidepressive Agents, Tricyclic / therapeutic use
Antifungal Agents / therapeutic use
Candidiasis, Vulvovaginal / complications*,  diagnosis,  drug therapy*
Carbamazepine / therapeutic use
Dyspareunia / etiology*
Follow-Up Studies
Hyperesthesia / complications*,  diagnosis,  drug therapy*
Ketoconazole / therapeutic use
Middle Aged
Prospective Studies
Risk Factors
Treatment Outcome
Vulvitis / complications*,  diagnosis,  drug therapy*
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Antidepressive Agents, Tricyclic; 0/Antifungal Agents; 298-46-4/Carbamazepine; 50-48-6/Amitriptyline; 65277-42-1/Ketoconazole
Comment In:
Aust N Z J Obstet Gynaecol. 1999 Aug;39(3):397   [PMID:  10554969 ]
Aust N Z J Obstet Gynaecol. 2000 Feb;40(1):108-9   [PMID:  10870796 ]

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