Parturition after vestibulectomy.
BACKGROUND
Provoked vestibulodynia is the most common cause of sexual pain in premenopausal women. Vulvar vestibulectomy has been shown to be an effective treatment.


OBJECTIVE
To determine the optimum route of parturition in women who become pregnant after vulvar vestibulectomy.


METHODS
All women who underwent a complete vulvar vestibulectomy by one of four surgeons were contacted between 12 and 72 months after surgery. For all women who had a term pregnancy and subsequent delivery, the research assistant abstracted data from the charts. Descriptive statistics were applied.


METHODS
The number of women who underwent a delivery after a vestibulectomy, mode of delivery, and rate of perineal lacerations.


RESULTS
Of 109 women, 44 (40%) had undergone at least one term pregnancy and delivery; 23 (52%) were vaginal, and 21 (48%) were cesarean deliveries. Of the vaginal deliveries, 11 (48%) were over an intact perineum. Three (13%) women had a midline episiotomy, none of which extended into third or fourth degree lacerations and one woman (4.4%) sustained a spontaneous fourth degree perineal laceration.


CONCLUSIONS
Vaginal delivery after vulvar vestibulectomy appears to be a safe option, with no increased perineal morbidity above the general population. Furthermore, it is not an indication for a cesarean delivery.
Burrows
Lara J
LJ
Summa-Health System, Akron, OH 44304, USA. burrowslj@yahoo.com
Sloane
Maryn
M
Davis
Gordon
G
Heller
Debra S
DS
Brooks
Joe
J
Goldstein
Andrew T
AT
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D022125:Lacerations; D036801:Parturition; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D018873:Pregnancy Rate; D012449:Safety; D056650:Vulvodynia / Q000601:surgery*