Korean J Urol.  2013 Jan;54(1):48-52.

A Retrospective Study of the Management of Vulvodynia

• Jeon Y
• Kim Y
• Shim B
• Yoon H
• Park Y
• Shim B
• Jeong W
• Lee D

Abstract

PURPOSE
Vulvodynia is characterized by chronic vulvar pain caused by sexual intercourse and often results in female sexual dysfunction. Because the causes of vulvodynia are not clear, many patients do not receive optimal treatment. Recently, gabapentin and botulinum toxin A have both been shown to be effective treatments for vulvodynia. In this study, we retrospectively analyzed the clinical outcomes of botulinum toxin A and gabapentin treatment for chronic pain in women with this condition.
MATERIALS AND METHODS
Seventy-three women with vulvar pain were administered either gabapentin (n=62) or botulinum toxin A (n=11) injections. Effectiveness was measured by use of a visual analogue scale (VAS). We analyzed the treatment method, treatment duration, success of treatment, and side effects or adverse reactions.
RESULTS
Pain levels in both groups significantly decreased after treatment. In the gabapentin group, the VAS score decreased from 8.6 before treatment to 3.2 after treatment (p<0.001). The VAS score in the botulinum toxin A group was reduced from 8.1 to 2.5 (p<0.001). Side effects for both therapies were few and subsided with treatment with general antibiotics and nonsteroidal antiinflammatory drugs.
CONCLUSIONS
Gabapentin and botulinum toxin A are safe and effective treatments for vulvodynia. This condition can cause sexual dysfunction and affect quality of life. However, with proper management, satisfactory outcomes for women with vulvodynia can be achieved.

Keyword

Dyspareunia; Gabapentin; Type A botulinum toxins; Vulvodynia

MeSH Terms

Amines
Anti-Bacterial Agents
Botulinum Toxins
Chronic Pain
Coitus
Cyclohexanecarboxylic Acids
Dyspareunia
Female
gamma-Aminobutyric Acid
Humans
Quality of Life
Retrospective Studies
Vulvodynia
Amines
Anti-Bacterial Agents
Botulinum Toxins
Cyclohexanecarboxylic Acids
gamma-Aminobutyric Acid

Figure

• 

  FIG. 1 The process of pain mapping and intralesional botulinum toxin A injection. (A) Using the Q-tip test, all painful areas were checked for intensity and localization. (B) Pain was scored by use of a visual analogue scale and mapped. (C) Botulinum toxin A was injected on the basis of the pain map (20 IU in each site, up to a maximal total dose of 100 IU).

• 

  FIG. 2 Pre- and posttreatment changes in visual analogue scale scores for the gabapentin and botulinum toxin A treatment groups.

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