Surgical and behavioral treatments for vestibulodynia: two-and-one-half year follow-up and predictors of outcome.
OBJECTIVE
To estimate whether treatment gains for provoked vestibulodynia participants randomly assigned to vestibulectomy, biofeedback, and cognitive-behavioral therapy in a previous study would be maintained from the last assessment-a 6-month follow-up-to the present 2.5-year follow-up. Although all three treatments yielded significant improvements at 6-month follow-up, vestibulectomy resulted in approximately twice the pain reduction as compared with the two other treatments. A second goal of the present study was to identify predictors of outcome.


METHODS
In a university hospital, 51 of the 78 women from the original study were reassessed 2.5 years after the end of their treatment. They completed 1) a gynecologic examination involving the cotton-swab test, 2) a structured interview, and 3) validated pain and sexual functioning measures.


RESULTS
Results from the multivariate analysis of variance conducted on the pain measures showed a significant time main effect (P<.05) and a significant treatment main effect (P<.01), indicating that participants had less pain at the 2.5-year follow-up than at the previous 6-month follow-up. Results from the multivariate analysis of variance conducted on sexual functioning measures showed that participants remained unchanged between the 6-month and 2.5-year follow-up and that there were no group differences. Higher pretreatment pain intensity predicted poorer outcomes at the 2.5-year follow-up for vestibulectomy (P<.01), biofeedback (P<.05), and cognitive-behavioral therapy (P<.01). Erotophobia also predicted a poorer outcome for vestibulectomy (P<.001).


CONCLUSIONS
Treatment gains were maintained at the 2.5-year follow-up. Outcome was predicted by pretreatment pain and psychosexual factors.


METHODS
II.
Bergeron
Sophie
S
Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada. bergeron.sophie@uqam.ca
Khalifé
Samir
S
Glazer
Howard I
HI
Binik
Yitzchak M
YM
D000328:Adult; D001676:Biofeedback, Psychology; D004414:Dyspareunia; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010147:Pain Measurement; D016896:Treatment Outcome; D014844:Vulva / Q000601:surgery*; D054515:Vulvar Vestibulitis / Q000523:psychology / Q000601:surgery* / Q000628:therapy*