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Review
. 2021 Jun 17:11:678961.
doi: 10.3389/fcimb.2021.678961. eCollection 2021.

Localized Provoked Vulvodynia-An Ignored Vulvar Pain Syndrome

Jorma Paavonen  1 , David A Eschenbach  2
Affiliations
Review

Localized Provoked Vulvodynia-An Ignored Vulvar Pain Syndrome

Jorma Paavonen et al. Front Cell Infect Microbiol. .

Abstract

Localized provoked vulvodynia (LPV) causes dyspareunia among reproductive aged women. We review the pathogenesis of LPV and suggest that LPV is an inflammatory pain syndrome of the vestibular mucosa triggered by microbial antigens in a susceptible host. Tissue inflammation and hyperinnervation are characteristic findings which explain symptoms and clinical signs. Education of health care providers of LPV is important since this condition is common, often unrecognized, and patients often become frustrated users of health care. Research is needed on the antigen triggers of the syndrome. Randomized clinical trials are needed to evaluate treatment modalities.

Keywords: localized provoked vulvodynia; vulvar pain; vulvar pain syndrome; vulvar vestibulitis syndrome; vulvodynia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Q-tip test. Vestibular point tenderness is tested at 2-, 5-, 6-, 7-, and 10-o’clock positions, and quantified as mild, moderate, or severe.
Figure 2
Figure 2
(A) Lymphoid aggregate in a vestibular biopsy from a patient with severe LPV; immunostaining for T cells and B cells. (B) Normal vestibular epithelium without inflammatory changes. Histological sections were counterstained with hematoxylin and photomicrographed using x10 objective. Adapted from Tommola P., et al., Am J Obstet Gynecol7; 2015;212(4):476.e1-8 (by permission).
Figure 3
Figure 3
Clinical algorithm developed by the authors and recommended for the management of patients with severe vulvar vestibulitis syndrome.
See this image and copyright information in PMC

References

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