Multilevel local anesthetic nerve blockade for the treatment of vulvar vestibulitis syndrome.
OBJECTIVE
Vulvar vestibulitis syndrome is a major cause of dyspareunia. This pilot study was designed to evaluate a novel treatment approach.


METHODS
This is a prospective study of 27 women with vulvar vestibulitis. The protocol included 5 treatment sessions with caudal epidural, pudendal nerve block, and vestibular infiltration of local anesthetic agents.


RESULTS
There were significant improvements in vestibular pain as determined by the vulvalgesiometer, McGill pain questionnaire, self-report, and the Female Sexual Functioning Inventory.


CONCLUSIONS
Serial multilevel nerve blocks administered for the treatment of vulvar vestibulitis is a conceptually neurophysiologically based modality that may be effective and merits a placebo-controlled study.
Rapkin
Andrea J
AJ
Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA Los Angeles, CA, USA.
McDonald
John S
JS
Morgan
Melinda
M
D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004414:Dyspareunia / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000187:drug effects; D017288:Pain Threshold / Q000187:drug effects; D017060:Patient Satisfaction; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D054515:Vulvar Vestibulitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*
D000779:Anesthetics, Local