052 Development of a Harmonized Multi-Site, Prospective Research Registry to Accelerate Evidence-Based Treatment of Sexual Disorders in Women and Girls with Cancer

Abstract

to any known direct injuries to her genital area. She began having “feelings” around age 6 and by age 9 she needed to cross her legs to help relieve symptoms. Results: MRI of the sacral spine S2-4 ruled out Tarlov cyst. No evidence of genital arousal: lubrication, swelling of clitoris or labia, was noted. She had a significant pain/grimacing response to umbilical hypersensitivity testing. Vulvoscopy revealed pubic hair consistent with Tanner Stage 3. Clitoris and hood were normal, both labia minora met at the posterior fourchette. Minor vulvar vestibular glands at 1, 3, 5, 6, 7, 9 and 11:00 oclock revealed moderate erythema with 8-9, 10, 10, 10, 10, 10 and 10/10 discomfort to cotton swab testing consistent with provoked vestibulodynia. Testosterone was low (9 ng/dl), SHBG 48 nmol/ L, calcu-lated free testosterone was low (0.126 ng/dl), dihydrotestosterone was <5 ng/dl, LH was 2.1, FSH was 4.9, estradiol was 37 pg/ml and progesterone was absent. A vestibular anesthesia test (VAT) was performed with topical bupivicaine, lidocaine, tetracaine between Hart’s line and intact hymen. She experienced loss of her “feeling” for the first time and there was a dramatic shift in mood and affect, going from tearful to giddy, happy, joking, and ambulating in the office halls. Local vestibular testosterone 0.1% and estradiol 0.02% cream x 6 months was not successful. Her current diagnosis is congenital neuro-proliferative vestibulodynia. Current management includes tramadol 2.5 mg TID and zolpidem 0.5 mg prn. She is considering complete vestibulectomy in 5 years when she is 18 years. Conclusion: PGAD in adolescents is a significant clinical challenge. Disclosure: Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.