Affiliation:
1. Luigi Vanvitelli University of Campania School of Medicine and Surgery, Naples, Italy
Abstract
Objective
Provoked vulvodynia (PV), characterized by vulvar pain upon touch or pressure, is the leading cause of pain during sexual intercourse. It causes a significant decline in overall quality of life, including sexual dysfunction and mental distress. Surgical interventions, such as perineoplasty and vestibulectomy, are considered a last resort for PV cases unresponsive to less invasive therapies. This systematic review evaluates the efficacy of surgery for PV and suggests areas for future research.
Materials and Methods
The literature search encompassed PubMed, Scopus, Web of Science, and Cochrane Library, identifying relevant peer-reviewed studies up to August 21, 2023.
Results
Out of 1102 records retrieved, 29 met the eligibility criteria. Surgery was typically considered after failed conservative treatments. In 15 of the 29 studies defining surgical success as a significant reduction in dyspareunia, success rates ranged from 52% to 93%. Six studies using validated scales for pain assessment noted a significant reduction in vulvar pain following surgery (p < .001). Two studies reported enhancements in sexual function ranging from 57% to 87%, while 3 studies found 89%–97% of women regained the ability to engage in sexual intercourse after surgery. Patient satisfaction rates ranged from 79% to 93%. Bartholin cysts occurred in up to 9% of cases, the most common complication reported.
Conclusion
Surgery seems to be an effective and safe PV treatment option with success rates ranging from 52% to 97%, depending on the variation of outcome measures. Randomized clinical trials with established outcome measures are needed to determine the best surgical approach with minimal operative risk and optimal long-term outcomes.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference61 articles.
1. 2015 ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia;J Sex Med,2016
2. A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?;J Am Med Womens Assoc (1972),2003
3. Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions;Am J Obstet Gynecol,2014
4. Co-morbid pain conditions and feelings of invalidation and isolation among women with vulvodynia;Psychol Health Med,2012
5. Pain, anxiety, depression, and quality of life in patients with vulvodynia;Dermatology,2020
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