Psychophysical evidence of nociceptor sensitization in vulvar vestibulitis syndrome.
Vulvar vestibulitis syndrome (VVS) is a long lasting disorder of superficial dyspareunia in young women. Quantitative sensory testing, including mechanical and temperature pain thresholds and warm/cold difference limen (WCL), was performed in the vestibular mucosa in 22 women (mean age 25.0 years) with vestibulitis and 20 control subjects (mean age 25.6 years). The tests were carried out on days 7-11 of the menstrual cycle. Patients had allodynia to mechanical testing with von Frey filaments, 14.3+/-3.1mN in the symptomatic posterior area as compared with 158+/-33.5mN in healthy subjects, P<0.0001. The pain threshold to heat was 38.6+/-0.6 degrees C in patients and 43.8+/-0.8 degrees C in controls, P<0.0001. In addition, pain threshold to cold was 21.6+/-1.2 degrees C in patients whereas cooling down to 6 degrees C was usually not painful in controls. WCL was 4.9+/-0.5 degrees C in patients and 9.6+/-1.5 degrees C in healthy subjects, P<0.01. The results are compatible with the hypothesis that patients with VVS have an increased innervation and/or sensitization of thermoreceptors and nociceptors in their vestibular mucosa.
Bohm-Starke
Nina
N
Division of Obstetrics and Gynaecology, Karolinska Institutet Danderyd Hospital, S-182 88 Danderyd, Sweden Division of Basic Oral Science, Karolinska Institutet, Huddinge, Sweden Department of Rehabilitation Medicine, Karolinska Hospital, Stockholm, Sweden Department of Clinical Neurophysiology, Uppsala University, Uppsala, Sweden.
Hilliges
Marita
M
Brodda-Jansen
Gunilla
G
Rylander
Eva
E
Torebjörk
Erik
E
D000328:Adult; D005260:Female; D006358:Hot Temperature; D006801:Humans; D009412:Nerve Fibers / Q000502:physiology; D009619:Nociceptors / Q000502:physiology*; D017288:Pain Threshold / Q000502:physiology / Q000523:psychology; D010812:Physical Stimulation; D011312:Pressure; D011601:Psychophysics; D014621:Vagina / Q000502:physiology; D014732:Vibration; D014844:Vulva / Q000294:innervation* / Q000503:physiopathology; D014847:Vulvitis / Q000503:physiopathology* / Q000523:psychology*