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Biores Open Access. 2019 Mar 8;8(1):25-31. doi: 10.1089/biores.2018.0044. eCollection 2019.

Combination of Treatments With or Without Surgery in Localized Provoked Vulvodynia: Outcomes After Three Years of Follow-Up.

Author information

1
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
2
Department of Obstetrics and Gynecology, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
3
Faculty of Social Sciences, University of Tampere, Tampere, Finland.
4
Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.

Abstract

Most vulvodynia patients receive combinations of several treatment modalities for their chronic painful condition. If conservative treatments fail, vestibulectomy is considered to be the ultimate treatment option for localized provoked vulvodynia (LPV). The aim of this descriptive study was to analyze relief of pain, quality of life (QoL), and complications associated with combining surgery with conservative treatments among LPV patients, both in short term and after 3 years of follow-up. The study population consisted of a retrospective patient cohort of surgically (n = 16) and only conservatively (n = 50) treated LPV patients. QoL data were assessed by a validated questionnaire (RAND-36). Data were collected by reviewing patient records and by aid of postal questionnaires. Efficacy of treatments in relief of pain was measured by numerical rating scale (NRS). Two months after surgery, the NRS scores assessed by a physician were lower in the surgery group than in patients treated only conservatively (p = 0.008). However, after a median of 36 months of follow-up, self-reported NRS scores and QoL showed no difference between the two patient cohorts. Complication rate after vestibulectomy was 18.8%. The findings suggest that combining surgery with conservative treatments may result in a more effective short-term reduction of pain. However, the effect seemed to be only temporary, as no long-term benefit was achieved.

KEYWORDS:

RAND-36; quality of life; vestibulectomy; vulvodynia; vulvodynia treatment

Conflict of interest statement

The authors (A.P.A., J.M., and S.S.) report conflict of interests. Authors (H.H.) report no conflict of interests. A.P.A. has received a congress travel grant from Roche. J.M. has received congress travel grant from AstraZeneca and Roche and has worked as a consultant for AstraZeneca, Tesaro, Roche, MSD, and Clovis. S.S. has received congress travel grants from Roche, Astra Zeneca, and Tesaro.

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