Therapy With Local Anesthetics to Treat Vulvodynia. A Pilot Study.

Abstract

IntroductionVulvodynia (chronic vulvar pain) is a sexually debilitating disorder with a prevalence of ∼10%.AimTo investigate the effectiveness of therapy with local anesthetics (TLA) in women with severe vulvodynia, we conducted a prospective, non-controlled observational study.Methods45 patients with severe chronic vulvodynia (primary and secondary vulvodynia, 0–10 numeric analogue scale (NAS) ≥6, median 7.9, duration ≥6 months, median 65.2 months) in an outpatient practice in Germany were treated with TLA in 3–12 sessions using procaine 1% as local anesthetic. Effectiveness was analyzed with Wilcoxon signed rank tests and Wilcoxon rank sum tests.OutcomesTherapeutic success as a reduction of pain to ≤4 NAS lasting for ≥6 months after end of therapy.ResultsTLA successfully reduced vulvodynia in 36 of 45 patients (80 %, responders). The NAS reduction was from 7.9 to 2.4 (P < .001). Even patients denominated as non-responders experienced a significant reduction in NAS (P = .03). In responders, long-term success was observed for 6.8–125 months (median 24.1 months). No adverse events occurred.Clinical TranslationA promising new treatment for a hard-to-treat chronic female pain disorder.Strengths and LimitationsLimitation: Monocentric, non-controlled observational design; Strength: the high number of patients treated.ConclusionThe high success rate of TLA in this investigation offers new perspectives on the etiology of vulvodynia as a complex pain syndrome affecting several nerves of the pelvic floor, and also provides early insight into the effectiveness of TLA in women with vulvodynia.Weinschenk S, Benrath J, Kessler E, et al. Therapy With Local Anesthetics to Treat Vulvodynia. A Pilot Study. Sex Med 2022;10:100482.