Vulvodynia is the term used to describe unexplained vulvar pain, sexual dysfunction, and the resultant psychological disability. In vulvar vestibulitis, surgery is carried out on patients who have failed conservative therapy. Surgical procedures which is removal of all sensitive vestibular tissue are most effective in patients with pure vestibulitis, but effective surgery is not known in patient with dysesthetic vulvodynia. We experienced one case of vulvar denervation operation in patients with intractable dysesthetic vulvodynia, which have failed conservative therapy. So we report one case with a brief review of literature.
Denervation* ; Humans ; Vulvar Vestibulitis ; Vulvodynia*

OBJECTIVE: This study was performed to evaluate and introduce the clinicopathologic characteristics and treatment modalities of vulvar vestibulitis, a subset of vulvodynia, may cause physical disabilities, phycological or emotional distress, sexual dysfunction and limitation of daily activities. But its etiologies and treatments are not defined yet. We want to summarize the diagnostic methods and treatments patients of vulvar vestibulitis syndrome, could be easily overlooked in your offices. METHODS: This retrospective study was based on medical records including pathologic reports of 30 patients who underwent skin biopsy among the patients who were diagnosed as vulvar vestibulitis syndrome from August 1999 to February 2002 at Kyung-Hee University Medical Center. Skin biopsy was taken at a most painful area of vestibule in Dermatology Department to improve the accuracy of diagnosis. We evaluated the clinicopathologic characteristics of patients RESULTS: The mean age of these patients was 53.4+/-10.4 years and the mean parity was 3.13+/-1.4 times. The mean duration from symptom onset to diagnosis was 26.2+/-24.1 months. The skin biopsies showed chronic inflammation in 21 cases (70.0%), chronic inflammation with koilocytosis in 5 cases (16.7%), subacute inflammation in 3 cases (10.0%), and acute inflammation in 1 case (3.3%). The most predominant painful area is right posterior vestibular site and all patients felt pain on that site with swab test. There were 70% improvement among 30 patients with non-surgical modalities. CONCLUSION: Vulvar vestibulitis syndrome is a syndrome of severe pain, burning, stinging, irritative or raw sensation within the vestibular area by vestibular touch or attempted vaginal entry such as tampon use or intercourse. It also has vestibular redness, urge to urinate frequently or suddenly and is confirmed by history, moistened cotton-tipped swab test and gentian violet staining on the lesions. Its prevalence is 15% and it is frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. Even though it could be seen frequently in our offices and has a tendency to become a chronic disease requiring long-term treatments, it has been being overlooked in offices due to lack of understanding of its etiologies, diagnostic criteria and treatments. Here we need more concerns and studies of vulvar vestibulitis syndrome.
Academic Medical Centers ; Biopsy ; Bites and Stings ; Burns ; Chronic Disease ; Dermatology ; Diagnosis ; Female ; Gentian Violet ; Humans ; Inflammation ; Medical Records ; Parity ; Prevalence ; Retrospective Studies ; Sensation ; Sexual Behavior ; Skin ; Vulvar Vestibulitis* ; Vulvodynia