DOCSLIB.ORG

Treatment of Vulvar Pain Syndrome

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Treatment of Vulvar Pain Syndrome N National V Vulvodynia AA Association Volume XIII, Issue II Spring 2008 Treatment of Vulvar Pain Syndrome By Sophie Bergeron, PhD, department of sexology, Université du Québec à Montréal, Quebec, and department of psychology, McGill University Health Centre, Montréal, Quebec; Caroline F. Pukall, PhD, department of psychology, Queen’s University, Kingston, Ontario; and Geneviève Mailloux, BSc department of psychology, Université du Québec à Montréal, Québec. Introduction The most common subtype of localized vulvar pain syndrome is provoked vestibulo dynia (PVD), also According to the most recent definition by the Interna- known as vulvar vestibulitis syndrome. It is character- tional Society for the Study of Vulvovaginal Disease ized by pain in the vulvar vestibule that is triggered (ISSVD), vulvar pain syndrome consists of “vulvar by contact, whether sexual or nonsexual, e.g., tampon discomfort, most often described as burning pain, oc- insertion. Dyspareunia, or painful intercourse, is one Thecurring classic in the definition absence of of vulvodyniarelevant visible is “vulvar findings pain, or ofthree its defining to six months symptoms duration and without the main a verifiable presenting cause com.’- burning,specific, rawness clinically or identifiable,irritation” present neurological for more disorder.” than six plaint.It was furtherPVD is decided considered that descriptorsthe most frequent such as general-form of months,A recent which population-based cannot be attributed study suggests to any thatother the cause. life- vulvarized or painlocalized syndrome be used in withpremenopausal an accurate women,pain map, with but Vulvartime cumulative vestibulitis incidence is a subset of vulvarof vulvodynia pain syndrome in which is prevalencethat further estimates sub-classification, ranging from such 12 percent as provoked in the gen- vs. the16 burningpercent, orindicating pain only that occurs approximately with light touch 14 million in the eralunprovoked, population was to not 15 warranted.percent in generalFor the remaindergynecologic of vestibule,women in the the area United immediately States surroundingalone may experience the vaginal practice.this article, Women the terms suffering generalized from PVD vulvodynia typically describeand vul- opening.idiopathic The vulvar International pain during Society their lifetime.for the Study of theirvar vestibulitis pain as a burning will be and/or utilized cutting for simplicity. sensation. Vulvovaginal Disease developed a new set of definitions forThere vulvodynia is currently in 2003. no Theywidely created accepted two subgroups: scheme that (i) Generalized vulvar pain syndrome, formerly known as localizedclassifies vulvodynia vulvar pain and syndrome (ii) generalized and differentiatesvulvodynia. dysesthetic or essentialSee PUDENDAL vulvodynia, NEURALGIA, is best described page 2 it from other types of pelvic or genital pain. Vulvar as a constant burning of the vulva, often including but pain syndrome is not included in disease classification not limited to the vestibule. The most common subtype systems, such as the International Classification of of generalized vulvodynia is unprovoked. Although MultilevelDisease (ICD-10), Nerve or in pain Blocksclassification in systems, the lessTreatment prevalent than PVD,of Vulvodynia it is thought to affect six to such as that of the International Association for the seven percent of women in the general population. ByStudy Andrea of Pain. In J. 2003, Rapkin, the ISSVD MD revised and Johnits classi S.- McDonald,Unprovoked generalized MD vulvodynia (UGVD) is often fication of vulvar pain syndrome based on two broad considered to be a more debilitating condition because Dr.types Rapkin of symptom is a professor presentations, of obstetrics namely and gynecology localized atof the the David chronic, Geffen unrelenting School of nature Medicine of the at thepain. Universityvulvar pain of Californiaand generalized – Los Angeles vulvar pain.(UCLA) Localized and the director of the UCLA Pelvic Pain Clinic. Dr. McDonald isrefers the chairman to the involvement of the department of a portion of anesthesiology of the vulva, and Inthe addition director to of disrupting the residency sexual training functioning program and interferat the - Harbor-UCLAsuch as the vulvar Medical vestibule, Center. and generalized indicates ing with the reproductive process, there is preliminary the involvementany characteristics of the entire of neuropathic vulva, composed or nerve of pain, the such as burning and extreme sensitivity to both painful labia majora,and nonpainful labia minora, stimuli clitoris, (hyperalgesia and vestibule. and allodynia, respectively), are also classic featuresSee TREATMENT, of vulvodynia. page 2 M Because there are no abnormal anatomic features associated with vulvodynia, the pain has been Thischaracterized article was as excerpted neuropathic with in permission etiology, ofand the in publisher, some cases, Informa a variant Healthcare, of pudendal from Urogenital neuropathy Pain or inneuralgia. Clinical PracticeNeuropathic by Drs. pain Andrew is a chronic P. Baranowski, abnormal statePaul thatAbrams, evolves and over Magnus time, Fall. ultimately Copyright leading © 2008 to aby number Informa of Healthcare changes in USA,the central Inc. This nervous book issystem available (brain at medical and spinal bookstores, cord) and online peripheral booksellers, (somatic at www.informaworld.co and autonomic) nervousm or system.by calling 1.800.634.7064. See NERVE BLOCKS, page 10 Treatment (from page 1) evidence to suggest that vulvar pain syndrome can with most attempts being unidimensional. In other adversely affect general psychological well-being and words, proposed interventions tend to focus solely on overall quality of life. Despite a high prevalence rate one aspect of vulvar pain syndrome to the exclusion and the fact that this urogenital pain condition was of others, and biopsychosocial models are the excep- first described over 100 years ago, there has been a tion. In our 1997 review of the literature on PVD, we paucity of sound research to elucidate its descriptive concluded that there were no effective treatments to characteristics, etiology, or treatment. In the understand- date because there were no existing randomized trials able urgency to treat women afflicted with vulvar pain comparing treatment and control groups. Since then, syndrome, interventions have been advanced without only a handful of randomized controlled treatment the benefit of randomized controlled outcome studies. studies have been published. This is surprising in light This has resulted in a variety of approaches which have of the fact that interest in vulvar pain has increased sig- no known efficacy. nificantly over the last five years. TREATMENT MEDICAL TREATMENTS Due to the lack of knowledge concerning the etiology Topical Applications of vulvar pain syndrome, the treatment literature is characterized by a wide variety of medical, surgical, Medical interventions typically begin with minimally cognitive-behavioral and alternative approaches di- invasive treatments such as the topical application of rected at different proposed mechanisms or symptoms, different types of antifungal, corticosteroid, estrogen or other creams. It has been our experience that some type of corticosteroid cream is the most commonly prescribed first-line treatment and that many women NVA News National Vulvodynia Association self-medicate with, or are prescribed, antifungal P.O. Box 4491, Silver Spring, Md. 20914-4491 agents. There is no published evidence, however, that (301) 299-0775; FAX: (301) 299-3999 any of these creams are efficacious. Cromolyn cream www.nva.org has also been suggested as a first-line treatment since it blocks mast cell degranulation, but studies examin- NVA News is published three times per year. ing the presence of mast cells in women with vulvar pain syndrome have yielded contradictory evidence. Editor: Interestingly, results from a randomized double-blind Phyllis Mate placebo study revealed that participants in both the therapy and the placebo groups exhibited statistically Contributor: Chris Veasley significant improvements in their symptoms, with no Layout: Andrea Hall significant differences between groups. These findings point toward a potentially large placebo effect in the The National Vulvodynia Association is an educational, treatment of vulvar pain syndrome, which has also been nonprofit organization founded to disseminate informa- documented in other pain syndromes. tion on treatment options for vulvodynia. The NVA recommends that you consult your own health care The use of topical anesthetics has long been recom- practitioner to determine which course of treatment or mended in the treatment of vulvar pain syndrome, but medication is appropriate for you. only recently has a prospective study examined its ef- fectiveness in women with PVD. Findings show that nightly applications of 5 percent lidocaine ointment NVA News, copyright 2008 by the National Vulvo- dynia Association, Inc. All Rights Reserved. Permis- for seven weeks resulted in a significant decrease in sion for republication of any article herein may be pain and a significant increase in the ability to have obtained by contacting the NVA Executive Director at 301-299-0775. See TREATMENT, page 3 Page 2 NVA News/Spring 2008 Treatment (from page 2) intercourse from pre- to post-treatment. However, the of the systemic antifungal did not improve the outcome lack of a placebo control
Load more

Recommended publications
  • NVA Research Update E- Newsletter September – October – November 2016
    NVA Research Update E- Newsletter September – October – November 2016 www.nva.org __________________________ Vulvodynia The Vulvar Pain Assessment Questionnaire inventory. Dargie E, Holden RR, Pukall CF. Pain. 2016 Aug 1. https://www.ncbi.nlm.nih.gov/pubmed/27780177 Millions suffer from chronic vulvar pain (ie, vulvodynia). Vulvodynia represents the intersection of 2 difficult subjects for health care professionals to tackle: sexuality and chronic pain. Those with chronic vulvar pain are often uncomfortable seeking help, and many who do so fail to receive proper diagnoses. The current research developed a multidimensional assessment questionnaire, the Vulvar Pain Assessment Questionnaire (VPAQ) inventory, to assist in the assessment and diagnosis of those with vulvar pain. A large pool of items was created to capture pain characteristics, emotional/cognitive functioning, physical functioning, coping skills, and partner factors. The item pool was subsequently administered online to 288 participants with chronic vulvar pain. Of those, 248 participants also completed previously established questionnaires that were used to evaluate the convergent and discriminant validity of the VPAQ. Exploratory factor analyses of the item pool established 6 primary scales: Pain Severity, Emotional Response, Cognitive Response, and Interference with Life, Sexual Function, and Self-Stimulation/Penetration. A brief screening version accompanies a more detailed version. In addition, 3 supplementary scales address pain quality characteristics, coping skills, and the impact on one's romantic relationship. When relationships among VPAQ scales and previously researched scales were examined, evidence of convergent and discriminant validity was observed. These patterns of findings are consistent with the literature on the multidimensional nature of vulvodynia. The VPAQ can be used for assessment, diagnosis, treatment formulation, and treatment monitoring.
    [Show full text]
  • Table of Contents
    Society for Sex Therapy and Research SSTAR 2008: 33rd Annual Meeting Continuing Medical Education Credit is provided through joint sponsorship with The American College of Obstetricians and Gynecologists (ACOG). Intercontinental Hotel Chicago, Illinois USA March 13-15, 2008 TABLE OF CONTENTS President‘s Welcome ..........................................................................................................1 SSTAR 2009: 34th Annual Meeting – Arlington, Virginia, USA ........................................2 SSTAR 2008 Fall Clinical Meeting – New York, New York USA ....................................2 SSTAR Executive Council and Administrative Staff ..........................................................3 Continuing Education Accreditations & Approvals ............................................................5 Acknowledgements ..............................................................................................................6 Program Schedule ................................................................................................................7 2008 Award Recipients ....................................................................................................14 SSTAR Health Professional Book Award .............................................................14 Sex, Therapy, and Kids Recipient: Sharon Lamb, EdD SSTAR Service Award ..........................................................................................14 Recipient: Bill Maurice, MD SSTAR Student Research Award Abstract ............................................................15
    [Show full text]
  • Co™™I™™Ee Opinion
    The American College of Obstetricians and Gynecologists WOMEN’S HEALTH CARE PHYSICIANS COMMITTEE OPINION Number 673 • September 2016 (Replaces Committee Opinion No. 345, October 2006) Committee on Gynecologic Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice and the American Society for Colposcopy and Cervical Pathology (ASCCP) in collaboration with committee member Ngozi Wexler, MD, MPH, and ASCCP members and experts Hope K. Haefner, MD, Herschel W. Lawson, MD, and Colleen K. Stockdale, MD, MS. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Persistent Vulvar Pain ABSTRACT: Persistent vulvar pain is a complex disorder that frequently is frustrating to the patient and the clinician. It can be difficult to treat and rapid resolution is unusual, even with appropriate therapy. Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. Specialists who may need to be involved include sexual counselors, clinical psychologists, physical therapists, and pain specialists. Patients may perceive this approach to mean the practitioner does not believe their pain is “real”; thus, it is important to begin any treatment approach with a detailed discussion, including an explanation of the diagnosis and determination of realistic treatment goals. Future research should aim at evaluating a multimodal approach in the treatment of vulvodynia, along with more research on the etiologies of vulvodynia.
    [Show full text]
  • Vulvar Pain Syndromes a Bounty of Treatments— but Not All of Them Are Proven
    second of 3 parTs VulVar paIn syndroMes a bounty of treatments— but not all of them are proven Treatments for vulvodynia and vestibulodynia range from lifestyle adjustments and application of topical agents to tricyclic antidepressants and nerve blocks— but the data on their efficacy are not as bountiful neal M. lonky, Md, MpH, moderator; libby edwards, Md, Jennifer Gunter, Md, and Hope K. Haefner, Md, panelists s we discussed in the first installment vulva. Cool gel packs are sometimes helpful. of this three-part series in the Sep- In thIs When it comes to intercourse, I recom- Article A tember issue of OBG Management, mend adequate lubrication using any of a the causes of vulvar pain are many, and the number of effective products, such as olive Therapies discussed diagnosis of this common complaint can be oil, vitamin E oil, Replens, Slippery Stuff, As- by the panel difficult. Once the diagnosis of vulvodynia troglide, KY Liquid, and others. page 34 has been made, however, the challenge shifts There is an extensive list of lubricants at to finding an effective treatment. Here, our http://www.med.umich.edu/sexualhealth/ How to determine expert panel discusses the many options resources/guide.htm which treatments available, the data (or lack of it) behind each are best therapy, and what to do in refractory cases. In Part 3 of this series, in the November Topical agents might offer relief page 35 issue, the focus will be vestibulodynia. —but so might placebo Dr. Lonky: What is the role of topical medi- Is physical therapy cations, including anesthetics, for treating underrated? Management of vulvar pain vulvar pain syndromes? page 38 begins with simple measures Dr.
    [Show full text]
  • The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: an ICS/ISSVD Best Practice Consensus Document
    Received: 30 November 2018 | Accepted: 3 January 2019 DOI: 10.1002/nau.23931 SOUNDING BOARD The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document Mario Preti MD1 | Pedro Vieira-Baptista MD2,3 | Giuseppe Alessandro Digesu PhD4 | Carol Emi Bretschneider MD5 | Margot Damaser PhD5,6,7 | Oktay Demirkesen MD8 | Debra S. Heller MD9 | Naside Mangir MD10,11 | Claudia Marchitelli MD12 | Sherif Mourad MD13 | Micheline Moyal-Barracco MD14 | Sol Peremateu MD12 | Visha Tailor MD4 | TufanTarcanMD15 | EliseJ.B.DeMD16 | Colleen K. Stockdale MD, MS17 1 Department of Obstetrics and Gynecology, University of Torino, Torino, Italy 2 Hospital Lusíadas Porto, Porto, Portugal 3 Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal 4 Department of Urogynaecology, Imperial College Healthcare, London, UK 5 Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio 6 Glickman Urological and Kidney Institute and Department of Biomedical Engineering Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 7 Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio 8 Faculty of Medicine, Department of Urology, Istanbul University Cerrahpaşa, Istanbul, Turkey 9 Department of Pathology and Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New Jersey 10 Kroto Research Institute, Department of Material Science and Engineering,
    [Show full text]
  • Reproductive Experiences Among Women with Vulvodynia Nora S
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Johnson et al. BMC Pregnancy and Childbirth (2015) 15:114 DOI 10.1186/s12884-015-0544-x RESEARCH ARTICLE Open Access “You have to go through it and have your children”: reproductive experiences among women with vulvodynia Nora S. Johnson, Eileen M. Harwood and Ruby H.N. Nguyen* Abstract Background: Vulvodynia is a potentially debilitating chronic pain condition affecting the vulva (external genitalia) in women, with typical age of onset during the early-to mid-reproductive years. Yet, virtually nothing is known about the thoughts, feelings and experience of vulvodynia patients regarding conception, pregnancy and delivery; including the effect that a hallmark symptom, dyspareunia (painful sex), can have on a couple’s physical and emotional ability to conceive. We sought to describe these experiences and beliefs among women with vulvodynia who were pregnant or who recently had delivered a child. Methods: The study used in-depth, qualitative exploratory interview methods to gain a deeper understanding of these experiences for 18 women with vulvar pain who were recruited from an existing, nationally-sampled prospective pregnancy cohort study. Results: Four major themes were reported by our participants. Women described their reaction to pain as volatile at first, and, over time, more self-controlled, regardless of medical treatment; once the volatility became more stable and overall severity lessened, many women began planning for pregnancy. Techniques described by women to cope with pain around pregnancy included pain minimization, planning pregnancy-safe treatment and timing intercourse around ovulation.
    [Show full text]
  • Vulvodynia: a Self-Help Guide
    Vulvodynia: A Self-Help Guide www.nva.org Table of Contents Introduction Introduction ..................................................................................... 1 Welcome to the NVA’s self-help guide for women with vulvodynia. We Section I: Learning the Basics ....................................................... 2 created this guide to answer many of your questions about vulvodynia and Gynecological Anatomy its treatment, and to offer suggestions for improving your quality of life. First Normal and Abnormal Vulvovaginal Symptoms we’d like to highlight a few important points. Vulvar Self-Examination Each woman’s experience with vulvodynia is unique, with symptoms ranging Section II: Understanding Vulvodynia ........................................... 9 from mild to incapacitating. If your pain level is mild, some of the information What is Vulvodynia? in this guide may not apply to you. What Causes Vulvodynia? How is Vulvodynia Diagnosed? Some doctors are still unfamiliar with vulvodynia. Many women spend a long Co-Existing Conditions time wondering what is wrong with them and see several doctors before How is Vulvodynia Treated? they are told they have vulvodynia. An accurate diagnosis is half the battle, Self-Help Strategies for Vulvar Pain so now you can focus your efforts on finding helpful treatments and feeling better. Section III: Understanding Chronic Pain ..................................... 17 How We Feel Pain When you start a new treatment, try to be patient and hopeful. There are When Pain Becomes Chronic many treatment options for vulvodynia and no single treatment works equally Coping with Chronic Pain well for all women. Sometimes progress is slow and you may only notice improvement on a monthly, rather than daily, basis. Section IV: Quality of Life Issues ................................................. 20 Overcoming Challenges in Your Intimate Relationship It is important to participate in treatment decisions and discuss your progress Keeping Sexual Intimacy Alive (or lack of it) with your doctor or other health care provider.
    [Show full text]
  • SJH Procedures
    SJH Procedures - Gynecology and Gynecology Oncology Services New Name Old Name CPT Code Service ABLATION, LESION, CERVIX AND VULVA, USING CO2 LASER LASER VAPORIZATION CERVIX/VULVA W CO2 LASER 56501 Destruction of lesion(s), vulva; simple (eg, laser surgery, Gynecology electrosurgery, cryosurgery, chemosurgery) 56515 Destruction of lesion(s), vulva; extensive (eg, laser surgery, Gynecology electrosurgery, cryosurgery, chemosurgery) 57513 Cautery of cervix; laser ablation Gynecology BIOPSY OR EXCISION, LESION, FACE AND NECK EXCISION/BIOPSY (MASS/LESION/LIPOMA/CYST) FACE/NECK General, Gynecology, Plastics, ENT, Maxillofacial BIOPSY OR EXCISION, LESION, FACE AND NECK, 2 OR MORE EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) MULTIPLE FACE/NECK 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, single lesion Aesthetics, Urology, Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11103 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, each separate/additional lesion (list separately in addition to Aesthetics, Urology, code for primary procedure) Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11104 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); single lesion Aesthetics, Urology, Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11105 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); each separate/additional lesion
    [Show full text]
  • Female Sexual Dysfunction Alessandra Graziottin
    266 PELVIC FLOOR DYSFUNCTION AND EVIDENCE-BASED PHYSICAL THERAPY Female sexual dysfunction Alessandra Graziottin ASSESSMENT Last, but not least, new insights into the role of the hyperactivity of the pelvic fl oor in adolescence and, Women’s sexuality has only recently emerged as a possibly, infanthood, as predictors of vulnerability to central concern after years of neglect in the medical further sexual pain disorders (vaginismus and dyspa- world. The current challenge is to blend together the reunia) and to vulvar vestibulitis/vulvodynia open a biological, psychosexual and context-related compo- new preventive window for female sexual dysfunctions nents of women’s sexual response in a comprehensive (FSD) (Chiozza & Graziottin 2004, Graziottin 2005a, and meaningful scenario (Basson et al 2000, 2004). In Harlow et al 2001). Appropriate management of early this perspective, the role of pelvic fl oor function and hyperactivity of the pelvic fl oor could hopefully prevent dysfunction is of the highest importance (Alvarez & the urogenital and sexual comorbidities that affect so Rockwell 2002, Bourcier et al 2004, Graziottin 2001a, many young lives. 2005a). In this book, dedicated to physical therapy for the Levator ani’s tone, strength and performance is a pelvic fl oor, FSD is reviewed paying special attention to major contributor to vaginal receptivity, vaginal respon- the genital components of women’s sexual response in siveness, coital competence and pleasure (for both part- physiological and pathological conditions. However, ners), and for the orgasmic muscular response. Indirectly, the role of the biological and medical factors should pelvic fl oor disorders (PFD) may impair genital arousal always be considered in the appropriate psychosexual and, through a negative feedback, may affect the poten- and sociocultural context.
    [Show full text]
  • Dk3608 C000 1..18
    3608_title 7/6/06 9:52 AM Page 1 Anatomy,The Physiology, Vulva and Pathology Edited by MirandaThe Procter & Gamble A. CompanyFarage Cincinnati, Ohio, U.S.A. HowardUniversity of California I. Maibach School of Medicine San Francisco, California, U.S.A. New York London Informa Healthcare USA, Inc. 270 Madison Avenue New York, NY 10016 © 2006 by Informa Healthcare USA, Inc. Informa Healthcare is an Informa business No claim to original U.S. Government works Printed in the United States of America on acid-free paper 10 9 8 7 6 5 4 3 2 1 International Standard Book Number-10: 0-8493-3608-2 (Hardcover) International Standard Book Number-13: 978-0-8493-3608-9 (Hardcover) This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the conse- quences of their use. No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopy- ing, microfilming, and recording, or in any information storage or retrieval system, without writ- ten permission from the publishers. For permission to photocopy or use material electronically from this work, please access www. copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC) 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400.
    [Show full text]
  • Current Uses of Surgery in the Treatment of Genital Pain Michelle King, Rachel Rubin & Andrew T. Goldstein
    Current Uses of Surgery in the Treatment of Genital Pain Michelle King, Rachel Rubin & Andrew T. Goldstein Current Sexual Health Reports ISSN 1548-3584 Curr Sex Health Rep DOI 10.1007/s11930-014-0032-8 1 23 Your article is protected by copyright and all rights are held exclusively by Springer Science+Business Media, LLC. This e-offprint is for personal use only and shall not be self- archived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com”. 1 23 Author's personal copy Curr Sex Health Rep DOI 10.1007/s11930-014-0032-8 FEMALE SEXUAL DYSFUNCTION AND DISORDERS (A GIRALDI AND L BROTTO, SECTION EDITORS) Current Uses of Surgery in the Treatment of Genital Pain Michelle King & Rachel Rubin & Andrew T. Goldstein # Springer Science+Business Media, LLC 2014 Abstract Genital pain frequently causes sexual dysfunction during sexual intercourse, vary greatly. However, it has and psychological distress that can impact every aspect of a been suggested that as many as 17–19 % of women woman’s life. When conservative medical treatments do not have a lifetime prevalence of dyspareunia [1].
    [Show full text]
  • Female Genital Cosmetic Surgery: a Review of Techniques and Outcomes
    Int Urogynecol J (2013) 24:1997–2009 DOI 10.1007/s00192-013-2117-8 REVIEW ARTICLE Female genital cosmetic surgery: a review of techniques and outcomes Cheryl B. Iglesia & Ladin Yurteri-Kaplan & Red Alinsod Received: 15 April 2013 /Accepted: 18 April 2013 /Published online: 22 May 2013 # The International Urogynecological Association 2013 Abstract The aesthetic and functional procedures that com- Keyword Female genital cosmetic surgery . Cosmetic prise female genital cosmetic surgery (FGCS) include tradi- gynecology . Vaginal rejuvenation . Labiaplasty . tional vaginal prolapse procedures as well as cosmetic Vaginoplasty vulvar and labial procedures. The line between cosmetic and medically indicated surgical procedures is blurred, and today many operations are performed for both purposes. The Introduction contributions of gynecologists and reconstructive pelvic surgeons are crucial in this debate. Aesthetic vaginal sur- Consumer marketing and media hype have spawned the con- geons may unintentionally blur legitimate female pelvic siderable controversy over female genital cosmetic surgery floor disorders with other aesthetic conditions. In the ab- (FGCS). FGCS articles first appeared in North American sence of quality outcome data, the value of FGCS in im- journals in 1978, and the first technical article appeared in proving sexual function remains uncertain. Women seeking 1984 [1, 2]. This review describes the techniques and outcome FGCS need to be educated about the range and variation of data of labiaplasty, vaginoplasty, and other cosmetic gyneco- labia widths and genital appearance, and should be evaluat- logical procedures. ed for true pelvic support disorders such as pelvic organ prolapse and stress urinary incontinence. Women seeking FGCS should also be screened for psychological conditions Female genital perceptions and should act autonomously without coercion from part- ners or surgeons with proprietary conflicts of interest.
    [Show full text]