Vestibular hyaluronic acid injection in provoked vestibulodynia patients and its effect on pain and sexual function: A preliminary report

•Hyaluronic acid injection to vulva is one of the treatment methods of vaginal dryness especially in postmenopausal women.•Vestibulodynia is a challenging problem for women, and it does not have a precisely defined treatment in patients without an etiology is found.•Women with vestibulodynia may benefit from vulvar hyaluronic acid injection. Provoked vestibulodynia (PVD) is a challenging and distressing problem for women. The aim of this study was to examine the effect of hyaluronic acid (HA) in the management of this condition. This is a retrospective review of 12 women diagnosed with PVD and treated with HA (19 mg/mL) applied, point-by-point, to the vestibular region at 2 mm intervals and at a depth of 0.5 mm. Women completed a pain VAS and a Female Sexual Function Index (FSFI) before and 45 days after treatment. An improvement was observed both in mean FSFI scores (17.8 to 23.3; p = 0.003) and mean VAS scores (7.2 to 4.1; p = 0.002) after HA application respectively. However, on a telephone interview 3 months post treatment, five women (41.7 %) complained of recurrence of their dyspareunia. HA is a promising management option in provoked vestibulodynia. However, further larger studies with possible alternative regimens and longer follow-up are required.