title: The major histopathologic characteristics in the vulvar vestibulitis syndrome.
abstract: OBJECTIVE
  In order to better understand the etiology of the vulvar vestibulitis syndrome, we examined the histopathologic parameters in vestibular mucosa, and compared the findings in specimens obtained from women with vulvar vestibulitis with those obtained from the control group.
  
  
  METHODS
  Specimens of vestibulitis were obtained from 24 patients, undergoing circumferential vestibulectomy under general anesthesia due to the symptoms and signs consistent with vulvar vestibulitis. Control specimens were obtained from 16 women, without symptoms or signs of vulvar vestibulitis, undergoing reconstructive introital surgery due to roomy vagina, rectocele or painful episiotomy. All vestibular tissue specimens were examined for intensity of inflammation, extension of inflammatory cells into the epithelium, vascular proliferation, the presence of mast cells and proliferation of peripheral nerve bundles.
  
  
  RESULTS
  No significant difference was found regarding the degree of inflammation, the extension of inflammatory cells into the epithelium, the vascular proliferation and the presence of mast cells while comparing the study and the control groups. The only histopathologic feature, differentiating the patients with vulvar vestibulitis from the control group, was the proliferation of peripheral nerve bundles found in 19 out of 24 (79.1%) specimens expressing vestibulitis and in none of 16 control specimens (p < 0.0001).
  
  
  CONCLUSIONS
  Our results, therefore, support the existence of peripheral nerve hyperplasia in vestibular tissue obtained from patients with vulvar vestibulitis, and exclude the role of active inflammation or mast cells as probable etiologies for the vulvar vestibulitis syndrome.
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel. maxia@asaf.health.gov.il
authors.forename: Reuvit
authors.initials: R
authors.lastname: Halperin
authors.forename: Sergei
authors.initials: S
authors.lastname: Zehavi
authors.forename: Zvika
authors.initials: Z
authors.lastname: Vaknin
authors.forename: Ido
authors.initials: I
authors.lastname: Ben-Ami
authors.forename: Moty
authors.initials: M
authors.lastname: Pansky
authors.forename: David
authors.initials: D
authors.lastname: Schneider
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009092:Mucous Membrane / Q000473:pathology; D010146:Pain / Q000209:etiology; D013577:Syndrome; D014844:Vulva / Q000473:pathology*; D014847:Vulvitis / Q000473:pathology*