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Obstet Gynecol. 2003 Jul;102(1):84-7.

Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis.

Author information

1
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7570, USA. denniz_zolnoun@med.unc.edu

Abstract

OBJECTIVE:

To assess the effectiveness of nightly application of 5% lidocaine ointment for treatment of vulvar vestibulitis.

METHODS:

Over 17 months, we assessed women presenting to our pain clinic for evaluation of introital pain; 61 women met the criteria for vulvar vestibulitis and participated in a treatment trial. We measured daily pain and intercourse-related pain using a 100-mm visual analog scale. We compared ability to have intercourse and pain ratings before and after treatment, and investigated whether prior treatment or gynecologic comorbidities predicted response to treatment.

RESULTS:

After a mean of 7 weeks of nightly treatment, 76% of women reported ability to have intercourse, compared with 36% before treatment (P =.002). Intercourse-related pain score was 39.11 (95% confidence interval [CI] 30.39, 47.83) points lower after treatment (P <.001), with a decrease of 10.37 (95% CI 3.53, 17.21) points in daily pain score (P =.004). We found no association between response to prior episodic use of lidocaine and response to nightly therapy with lidocaine ointment. Few patient characteristics predicted response to treatment; however, women with interstitial cystitis and other vulvar conditions were least likely to benefit.

CONCLUSION:

Long-term, nightly application of 5% lidocaine ointment shows promise as a treatment for management of vulvar vestibulitis; a randomized, double-blind, clinical trial is warranted.

PMID:
12850611
DOI:
10.1016/s0029-7844(03)00368-5
[Indexed for MEDLINE]

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