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Vulvar vestibulitis syndrome and vaginismus: A case report
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.ORCID-id: 0000-0002-2902-7077
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Kirurgi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
Vise andre og tillknytning
2000 (engelsk)Inngår i: Journal of reproductive medicine, ISSN 0024-7758, E-ISSN 1943-3565, Vol. 45, s. 219-223Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Recent reports have argued for a revision of the criteria used for the establishment of a diagnosis of vulvar vestibulitis syndrome (VVS). On theoretical grounds it might be hypothesized that women with VVS also suffer from vaginismus.

CASE: A young woman presented with a history, symptoms and objective findings typical of vaginismus, yet she suffered from continuous, burning pain and itching in the vestibule. Earlier in the course of the problem she had received a diagnosis VVS. The patient was treated with behavioral therapy developed for vaginismus. Notations made during the course of therapy supported the assumption that the pain and itching were conditioned responses to penetration in the same way that a vaginal muscular reflex is.

 

CONCLUSION: Differential diagnostic difficulties exist in the field of VVS and vaginismus. Psychophysiologic theories are needed as the basis for research to clarify the connections between different diagnostic entities associated with coital burning pain and itching in the vestibule.

sted, utgiver, år, opplag, sider
2000. Vol. 45, s. 219-223
Emneord [en]
vulva, vestibule, vaginismus, vestibulitis
HSV kategori
Identifikatorer
URN: urn:nbn:se:liu:diva-12653OAI: oai:DiVA.org:liu-12653DiVA, id: diva2:16782
Tilgjengelig fra: 2007-10-17 Laget: 2007-10-17 Sist oppdatert: 2018-11-15
Inngår i avhandling
1. Partial vaginismus: definition, symptoms and treatment
Åpne denne publikasjonen i ny fane eller vindu >>Partial vaginismus: definition, symptoms and treatment
2007 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Vaginismus is a sexual pain disorder, where spasm of musculature of the outer third of the vagina interferes with intercourse. Vaginismus exists in two forms: total vaginismus, where intercourse is impossible, and the more seldom described partial vaginismus, in which intercourse is possible but painful.

The aim of the thesis was to develop a useful definition of partial vaginismus for both clinical and scientific purposes; to describe the prevalence of partial vaginismus among women with superficial coital pain; to report on symptoms and clinical findings in women with partial vaginismus; and to present treatment results for women with vaginismus.

In a clinical sample of 224 women with superficial coital pain, we found a great overlap of the clinical diagnoses of partial vaginismus (PaV) and vulvar vestibulitis (VVS) (nowadays called provoked vestibulodynia); 102 women had both PaV and VVS. All women with VVS had vaginismus. Partial vaginismus was more common in all our samples than total vaginismus.

sEMG of pelvic floor muscles was found to be of no value in distinguishing women with partial vaginismus with or without vulvar vestibulitis (PaV+/-VVS) (n=47) from each other or from an asymptomatic group (n=27).

Women with PaV+/-VVS (n=53) reported not only burning pain but also itch during a standardized penetration situation (sEMG of pelvic floor muscles), while asymptomatic women (n=27) did not. In most cases, the appearance of burning pain preceded the appearance of itch.

In a retrospective interview study, 24 women with PaV+/-VVS reported pain after intercourse more often than pain during penetration at the onset of the problem. When the women ceased having intercourse, both symptoms were equally common. Intensity of pain during penetration increased dramatically from very low at onset of the problem to very high when the women ceased having intercourse, while intensity of pain after intercourse was already high at onset of the problem and increased to very high when the women ceased having intercourse.

Pain after intercourse in women with PaV+/-VVS was described as burning and/or smarting and lasted in mean for two hours, while pain during penetration was described with words like sharp/incisive/bursting and lasted for one minute.

At long-term follow-up (more than three years) of a group of women treated with cognitive behaviour therapy for vaginismus (n=59, response rate 44/59 on a questionnaire), a majority were able to have and enjoy intercourse. The proportion of women with positive treatment outcome was, however, associated to the definition of treatment outcome. An ability to have intercourse at end of therapy was maintained at follow-up. Every tenth women with vaginismus healed spontaneously after thorough assessment.

Conclusion: Partial vaginismus was more common in our studies than total vaginismus, and all women with vulvar vestibulitis had partial vaginismus. Women with PaV+/-VVS reported not only burning pain during standardized penetration but also itch. When the problem started in women with PaV+/-VVS, pain after intercourse was more common than pain during penetration. Pain after intercourse was described as longlasting and burning and/or smarting, while pain during penetration was described as short and sharp/incisive/bursting. Long-term follow-up results of a series of women treated with CBT for vaginismus show good treatment outcome.

sted, utgiver, år, opplag, sider
Institutionen för klinisk och experimentell medicin, 2007
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1015
Emneord
Partial vaginismus, vulvar vestibulitis, provoked vestibulodynia, electromyography, pelvic floor muscles, burning pain, itch, symptoms, long-term follow-up, cognitive behaviour therapy
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-10036 (URN)978-91-85895-92-2 (ISBN)
Disputas
2007-11-20, Aulan, Hälsans hus, Campus US, Linköpings universitet, Linköping, 13:00 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2007-10-17 Laget: 2007-10-17 Sist oppdatert: 2018-11-15

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Wijma, BarboJansson Engman, MariaHallböök, OlofWijma, Klaas

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