Vulvar Endometriosis Mimicking as Primary Vulvodynia in a Young Nulliparous Woman: Algorithm of Care Following a Rapid Literature Review

Abstract

Endometriosis occurs in 10% of women aged 19 - 45 years. There is a rare incidence of spontaneous vulvar endometriosis, a possible subset of cutaneous endometriosis. Few cases of vulvar endometriosis have been reported in literature and are often related to large lesions. The occult cases of vulvar endometriosis have been identified mistakenly following response to hormone use after being misdiagnosed as intractable primary vulvodynia. With this mis- or delayed diagnosis comes increased psychological distress adding to the burden of disease. This management algorithm following a rapid literature review of cases using recognized databases such as PubMed, Medline, SCOPUS, CINAHL and EMBASE addresses the needs of this group of vulvar endometriosis. Vulvar endometriosis is rare and can present as primary vulvodynia in the young woman. It may mimic vulvodynia or other chronic pelvic pain disorders such as interstitial cystitis leading to conflicting management. However, a strong correlation of vulvar pain or discomfort to her menstrual cycle activity with or without a visible lesion should raise the likelihood of this condition. J Clin Gynecol Obstet. 2021;10(2):35-39 doi: https://doi.org/10.14740/jcgo735