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. 2019 Aug;108(10):685-691.
doi: 10.1024/1661-8157/a003274.

[Vulvodynia - Diagnostics and Management Strategies]

[Article in German]
Affiliations

[Vulvodynia - Diagnostics and Management Strategies]

[Article in German]
Gian-Piero Ghisu. Praxis (Bern 1994). 2019 Aug.

Abstract

Vulvodynia - Diagnostics and Management Strategies Abstract. Vulvodynia is characterized by chronic, idiopathic vulvar pain lasting for at least three months. After exclusion of other, specific diseases associated with vulvar pain, which can be treated accordingly, realistic therapy goals for this chronic disease should be defined. The therapy concept is multimodal, interdisciplinary as well as individualized and includes the combination of general recommendations with physiotherapeutic and psychotherapeutic measures. Pharmacological therapy, which is indispensable, is carried out off-label and includes the topical and/or systemic use of various substances and substance combinations. Surgical measures may be regarded as a possible option, especially in women with therapy-resistant and provocable vulvodynia. Alternative therapy options such as acupuncture, hypnosis and transcutaneous electrical nerve stimulation are also worth investigating.

Zusammenfassung. Die Vulvodynie ist durch chronische, idiopathische, mindestens drei Monate andauernde vulväre Schmerzen definiert. Nach Ausschluss spezifischer und gezielt behandelbarer schmerzhafter Vulvaerkrankungen sollten realistische Therapieziele der chronisch verlaufenden Vulvodynie vereinbart werden. Das Therapiekonzept wird multimodal, interdisziplinär und individualisiert erstellt und umfasst die Kombination allgemeiner Empfehlungen mit physio- und psychotherapeutischen Massnahmen. Die unentbehrliche pharmakologische Therapie erfolgt im Off-Label Use und sieht den topischen und/oder systemischen Einsatz verschiedener Substanzen und Substanzkombinationen vor. Chirurgische Möglichkeiten sind gerade bei Frauen mit therapieresistenter provozierbarer Vulvodynie als mögliche Option anzusehen. So sind auch alternative Therapiemöglichkeiten wie Akupunktur, Hypnose und transkutane elektrische Nervenstimulation prüfenswert.

Keywords: Douleurs vulvaires; Multimodales Therapiekonzept; Vulvar pain; Vulvodynie; Vulväre Schmerzen; concept thérapeutique multimodal; medical therapy; medikamentöse Therapie; multimodal therapy concept; traitement médicamenteux; vulvodynia; vulvodynie.

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