title: Umbilical hypersensitivity in women with primary vestibulodynia.
abstract: OBJECTIVE
  To provide evidence that primary vestibulodynia (PV) is a congenital defect in tissue derived from the primitive urogenital sinus.
  
  
  METHODS
  Twenty-two women with PV, 16 with secondary vestibulodynia (SV) and 8 controls were included in this study. Subjects underwent a complete history and physical examination, including assessment with a vulvalgesiometer to measure the sensory and pain detection thresholds in the vulvar vestibule, deltoid and umbilicus.
  
  
  RESULTS
  The median vestibular sensitivity was 5 g in the PV group and 10 g in the SV group (p= 0.77). The median umbilical pain thresholds for the PV, SV and control groups were 115, 675 and 500 g, respectively. Women with PV displayed a significantly higher level of umbilical sensitivity (a substantially lower pain threshold) compared with women with SV and the control group (p = 0.0001 and 0.002, respectively). There was no difference in umbilical sensitivity between the SV and control groups.
  
  
  CONCLUSIONS
  Because both the umbilicus and vulvar vestibule are derived from primitive urogenital sinus, this suggests that women with PV may have a congenital abnormality in urogenital - sinus-derived epithelium.
authors.affiliation: Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, St. Francis Hospital and Medical Center, Hartford, Connecticut, USA. burrowslj@yahoo.com
authors.forename: Lara J
authors.initials: LJ
authors.lastname: Burrows
authors.forename: Daisy
authors.initials: D
authors.lastname: Klingman
authors.forename: Caroline F
authors.initials: CF
authors.lastname: Pukall
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000503:physiopathology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation; D012782:Shoulder; D014472:Umbilicus; D054515:Vulvar Vestibulitis / Q000209:etiology / Q000503:physiopathology*