Addressing vulvodynia in a chronic pelvic pain unit, does it make any difference?

Abstract

Vulvodynia is a chronic painful entity that poses diagnostic and therapeutic challenges. The aim of this work was to describe the characteristics of women affected by vulvodynia and to estimate the effectiveness of currently available therapeutic options. A retrospective observational study has been carried out with a sample of 50 women who presented vulvodynia at a chronic pelvic pain unit between 2019 and 2021. The mean age at diagnosis was 38.44 years. Mean delay to diagnosis was 29.82 months. According to the classification currently used, vulvodynia was mainly localized, provoked, intermittent, and immediate. Most of the women also reported dyspareunia with mean baseline pain and dyspareunia according to the Visual Analog Scale (VAS) of 4 and 8, respectively. Among the therapeutic options used, neuromodulatory drugs have shown to be effective in symptom control and improving quality of life both at 6 and 12 months. At 24 months improvement in dyspareunia was not statistically significant, probably due to the small sample size due to losses in the follow-up. Non-pharmacological treatments such as physical therapy and cognitive behavioral therapy may also play a role in symptom improvement. Most of the available evidence is based on retrospective studies. Quality randomized clinical trials are necessary to better test the efficacy of treatments, especially neuromodulatory drugs.