Gynecology Book

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Localized Vulvar DysesthesiaAka: Localized Vulvodynia, Vestibulodynia, Vulvar Vestibulitis, Focal Vulvitis

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  1. See Also
    1. Vulvodynia
    2. Generalized Vulvar Dysesthesia
  2. Definition
    1. Localized Vulvar Dysesthesia (Localized Vulvodynia)
      1. Localized Vulvar Pain without dermatitis
      2. Vulvar Vestibulitis is misnomer and no longer used
  3. Epidemiology
    1. Affects premenopausal women most commonly
  4. Etiology
    1. Unknown
    2. Possible causes
      1. Yeast Vaginitis
      2. Chemical irritants
      3. Local destructive therapy (CO2 Laser or Cryotherapy)
      4. Allergic Drug Reactions
      5. Human papillomavirus
  5. Symptoms and signs
    1. Persistent Dyspareunia at introitus
      1. Pain on penis or tampon entry
    2. Focal or diffuse erythema at vestibule
    3. Point tenderness at minor vestibular glands
      1. Swab lightly touched over area causes local pain
  6. Differential Diagnosis
    1. See Vulvodynia for differential diagnosis
    2. Signs active infection suggests other diagnosis
    3. Concurrent dermatitis suggests other diagnosis
  7. Course
    1. Lasts for months to years
  8. Management
    1. See Vulvodynia
  9. References
    1. Black (1995) OBGyn Dermatology, Mosby-Wolfe
    2. Apgar (1996) Am Fam Physician 53(4):1171
    3. Barhan (1997) Postgrad Med 102(3):121
    4. Metts (1999) Am Fam Physician 59(6):1547

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