The result of treatment on vestibular and general pain thresholds in women with provoked vestibulodynia.
OBJECTIVE
To correlate changes in vestibular pain thresholds to general pain thresholds in a subgroup of women with provoked vestibulodynia taking part in a treatment study.


METHODS
Thirty-five women with provoked vestibulodynia were randomized to 4 months' treatment with either electromyographic biofeedback (n=17) or topical lidocaine (n=18). Vestibular and general pressure pain thresholds (PPTs) were measured and the health survey Short Form-36 (SF-36) was filled out before treatment and at a 6-month follow-up. Subjective treatment outcome and bodily pain were analyzed. Thirty healthy women of the same age served as controls for general PPTs and SF-36.


RESULTS
No differences in outcome measures were observed between the 2 treatments. Vestibular pain thresholds increased from median 30 g before to 70 g after treatment in the anterior vestibule (P<0.001) and from median 20 to 30 g in the posterior vestibule (P<0.001). PPTs on the leg and arm were lower in the patients as compared with controls both before and at the 6-month follow-up. Patients reporting total cure were 3/35; 25/35 were improved. The number of patients who frequently reported of other bodily pain was reduced after the treatment. The patients had lower scores for SF-36 (General Health, Vitality) before treatment, which was restored at the 6-month follow-up.


CONCLUSIONS
Treating provoked vestibulodynia by either topical lidocaine or electromyographic biofeedback increased vestibular pain thresholds, reduced dyspareunia, and improved bodily pain. The patients showed a general hypersensitivity to pressure pain compared with controls and in this study the hypersensitivity did not seem to be affected by treating the superficial dyspareunia.
Bohm-Starke
Nina
N
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. nina.bohm-starke@ds.se
Brodda-Jansen
Gunilla
G
Linder
Jürgen
J
Danielsson
Ingela
I
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis* / Q000628:therapy*; D010146:Pain / Q000175:diagnosis*; D059408:Pain Management; D010147:Pain Measurement; D017288:Pain Threshold; D013577:Syndrome; D016896:Treatment Outcome; D014847:Vulvitis / Q000175:diagnosis* / Q000628:therapy*