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Case 13 - A 33-Year-Old Woman with Localized Vulvodynia without Vaginismus

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 33-year-old nulligravid woman presents with a complaint of insertional dyspareunia. She has been partnered with the same man for three years and had no issues with coitus until about one year ago. Since that time, she has experienced increasingly severe pain with any attempt at vaginal insertion. She describes the pain as sharp and tearing, occurring when her partner enters her. Because of the pain, she has also experienced diminished arousal and a lack of sexual desire. She denies any vulvar pain in other situations but has a similar sensation with placement of a tampon or sex toy. A trial of topical estrogen worsened her symptoms. Application of lidocaine jelly to the area resulted in improvement of symptoms temporarily, but intercourse without it was persistently painful. Her gynecologic history is notable only for a history of recurrent candida vaginitis, though she has no symptoms currently. She uses a combined oral contraceptive for birth control. She has no significant medical history and has never had surgery. She is a non-smoker and uses alcohol occasionally.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 34 - 36
Publisher: Cambridge University Press
Print publication year: 2021

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References

Stenson, AL. Vulvodynia: diagnosis and management. Obstet Gynecol Clin North Am 2017; 44: 493508.CrossRefGoogle ScholarPubMed
Pukall, CF, Goldstein, AT, Bergeron, S, et al. Vulvodynia: definition, prevalence, impact, and pathophysiological factors. J Sex Med 2016; 13: 291304.CrossRefGoogle ScholarPubMed
Brotto, LA, Sadownik, LA, Thomson, S, et al. A comparison of demographic and psychosexual characteristics of women with primary versus secondary provoked vestibulodynia. Clin J Pain 2014; 30: 428–35.CrossRefGoogle ScholarPubMed
Goetsch, MF, Morgan, TK, Korcheva, VB, et al. Histologic and receptor analysis of primary and secondary vestibulodynia and controls: a prospective study. Am J Obstet Gynecol 2010; 202: 614.e18.CrossRefGoogle ScholarPubMed
Landry, T, Bergeron, S, Dupuis, M-J, Desrochers, G. The treatment of provoked vestibulodynia: a critical review. Clin J Pain 2008; 24: 155–71.CrossRefGoogle ScholarPubMed
Reed, BD, Haefner, HK, Sen, A, Gorenflo, DW. Vulvodynia incidence and remission rates among adult women: a 2-year follow-up study. Obstet Gynecol 2008; 112: 231–7.CrossRefGoogle ScholarPubMed
Tommola, P, Unkila-Kallio, L, Paavonen, J. Surgical treatment of vulvar vestibulitis: a review. Acta Obstet Gynecol Scand 2010; 89: 1385–95.CrossRefGoogle ScholarPubMed
Goetsch, MF. Simplified surgical revision of the vulvar vestibule for vulvar vestibulitis. Am J Obstet Gynecol 1996; 174: 1701–7.CrossRefGoogle ScholarPubMed
Tommola, P, Unkila-Kallio, L, Paavonen, J. Long-term follow up of posterior vestibulectomy for treating vulvar vestibulitis. Acta Obstet Gynecol Scand 2011; 90: 1225–31.CrossRefGoogle ScholarPubMed

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