Managing Vulvodynia with Central Sensitization: Challenges and Strategies
: Vulvodynia is defined as a chronic idiopathic vulvar pain condition. This study aimed to investigate the effect of central sensitization on the prognosis of neuromodulator treatment for vulvodynia. A total of 105 patients with vulvodynia who underwent pelvic mapping pain exploration were included...
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| Veröffentlicht in: | Journal of clinical medicine 2023-06, Vol.12 (11), p.3851 |
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| container_title | Journal of clinical medicine |
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| creator | Rubal, Cristina Pereira, Augusto Sastre, Laura Calles Pérez-Cejuela, Belén Almoguera Gámiz, Sofía Herrero Chaves, Pilar Medina, Tirso Pérez |
| description | : Vulvodynia is defined as a chronic idiopathic vulvar pain condition. This study aimed to investigate the effect of central sensitization on the prognosis of neuromodulator treatment for vulvodynia.
A total of 105 patients with vulvodynia who underwent pelvic mapping pain exploration were included and scored according to the Convergence PP Criteria for pelvic pain and central sensitization. The patients were treated according to chronic pelvic pain guidelines, and their response to treatment was evaluated.
A total of 35 out 105 patients (33%) with vulvodynia had central sensitization, which was associated with comorbidities, dyspareunia, pain with micturition, and pain with defecation. Dyspareunia and pain with defecation were independent prognostic factors for central sensitization. Patients with central sensitization experienced more pain during intercourse, urination, or defecation, had more comorbidities, and responded worse to treatment. They required more treatment, with a longer response time (over 2 months). Patients with localized vulvodynia were treated with physiotherapy and lidocaine, while patients with generalized vulvodynia were treated with neuromodulators. Amitriptyline was effective in treating patients with generalized spontaneous vulvodynia and dyspareunia.
Overall, this study highlights the importance of considering central sensitization in the diagnosis and treatment of vulvodynia and the need for individualized treatment based on the patient's symptoms and underlying mechanisms. Vulvodynia patients with central sensitization had more pain during intercourse, urination, or defecation, and responded worse to treatment, requiring more time and medication. |
| doi_str_mv | 10.3390/jcm12113851 |
| format | Article |
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A total of 105 patients with vulvodynia who underwent pelvic mapping pain exploration were included and scored according to the Convergence PP Criteria for pelvic pain and central sensitization. The patients were treated according to chronic pelvic pain guidelines, and their response to treatment was evaluated.
A total of 35 out 105 patients (33%) with vulvodynia had central sensitization, which was associated with comorbidities, dyspareunia, pain with micturition, and pain with defecation. Dyspareunia and pain with defecation were independent prognostic factors for central sensitization. Patients with central sensitization experienced more pain during intercourse, urination, or defecation, had more comorbidities, and responded worse to treatment. They required more treatment, with a longer response time (over 2 months). Patients with localized vulvodynia were treated with physiotherapy and lidocaine, while patients with generalized vulvodynia were treated with neuromodulators. Amitriptyline was effective in treating patients with generalized spontaneous vulvodynia and dyspareunia.
Overall, this study highlights the importance of considering central sensitization in the diagnosis and treatment of vulvodynia and the need for individualized treatment based on the patient's symptoms and underlying mechanisms. Vulvodynia patients with central sensitization had more pain during intercourse, urination, or defecation, and responded worse to treatment, requiring more time and medication.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12113851</identifier><identifier>PMID: 37298046</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Care and treatment ; Chronic fatigue syndrome ; Clinical medicine ; Clitoris ; Complications and side effects ; Defecation ; Fibromyalgia ; Health aspects ; Hyperalgesia ; Inflammation ; Irritable bowel syndrome ; Nervous system ; Nociception ; Obstetrics ; Pain ; Patients ; Peptides ; Physical therapy ; Prognosis ; Restless legs syndrome ; Sexual intercourse ; Vagina ; Vulvodynia</subject><ispartof>Journal of clinical medicine, 2023-06, Vol.12 (11), p.3851</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-ec0781dd8d5196c8d6441becb15dcbc7ccb9b4ecb42f6b71985bef242e66bcaf3</citedby><cites>FETCH-LOGICAL-c477t-ec0781dd8d5196c8d6441becb15dcbc7ccb9b4ecb42f6b71985bef242e66bcaf3</cites><orcidid>0000-0003-2534-1007 ; 0000-0003-4560-453X ; 0000-0002-4735-0644</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253424/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253424/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37298046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rubal, Cristina</creatorcontrib><creatorcontrib>Pereira, Augusto</creatorcontrib><creatorcontrib>Sastre, Laura Calles</creatorcontrib><creatorcontrib>Pérez-Cejuela, Belén Almoguera</creatorcontrib><creatorcontrib>Gámiz, Sofía Herrero</creatorcontrib><creatorcontrib>Chaves, Pilar</creatorcontrib><creatorcontrib>Medina, Tirso Pérez</creatorcontrib><title>Managing Vulvodynia with Central Sensitization: Challenges and Strategies</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>: Vulvodynia is defined as a chronic idiopathic vulvar pain condition. This study aimed to investigate the effect of central sensitization on the prognosis of neuromodulator treatment for vulvodynia.
A total of 105 patients with vulvodynia who underwent pelvic mapping pain exploration were included and scored according to the Convergence PP Criteria for pelvic pain and central sensitization. The patients were treated according to chronic pelvic pain guidelines, and their response to treatment was evaluated.
A total of 35 out 105 patients (33%) with vulvodynia had central sensitization, which was associated with comorbidities, dyspareunia, pain with micturition, and pain with defecation. Dyspareunia and pain with defecation were independent prognostic factors for central sensitization. Patients with central sensitization experienced more pain during intercourse, urination, or defecation, had more comorbidities, and responded worse to treatment. They required more treatment, with a longer response time (over 2 months). Patients with localized vulvodynia were treated with physiotherapy and lidocaine, while patients with generalized vulvodynia were treated with neuromodulators. Amitriptyline was effective in treating patients with generalized spontaneous vulvodynia and dyspareunia.
Overall, this study highlights the importance of considering central sensitization in the diagnosis and treatment of vulvodynia and the need for individualized treatment based on the patient's symptoms and underlying mechanisms. Vulvodynia patients with central sensitization had more pain during intercourse, urination, or defecation, and responded worse to treatment, requiring more time and medication.</description><subject>Care and treatment</subject><subject>Chronic fatigue syndrome</subject><subject>Clinical medicine</subject><subject>Clitoris</subject><subject>Complications and side effects</subject><subject>Defecation</subject><subject>Fibromyalgia</subject><subject>Health aspects</subject><subject>Hyperalgesia</subject><subject>Inflammation</subject><subject>Irritable bowel syndrome</subject><subject>Nervous system</subject><subject>Nociception</subject><subject>Obstetrics</subject><subject>Pain</subject><subject>Patients</subject><subject>Peptides</subject><subject>Physical therapy</subject><subject>Prognosis</subject><subject>Restless legs syndrome</subject><subject>Sexual intercourse</subject><subject>Vagina</subject><subject>Vulvodynia</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptkctP3DAQxi3UChBw4o4icamEFvxK7HBBaNUHElUPtFwtPyZZrxIb4oSK_vX1slu0oNoHj-3ffOPxh9AxweeM1fhiaXtCCWGyJDton2IhZphJ9mEr3kNHKS1xHlJySsQu2mOC1hLzah_dfNdBtz60xf3UPUX3HLwufvtxUcwhjIPuijsIyY_-jx59DJfFfKG7DkILqdDBFXeZGaH1kA7Rx0Z3CY426wH69eXzz_m32e2Przfz69uZ5UKMM7BYSOKcdCWpKytdxTkxYA0pnTVWWGtqw_Oe06YygtSyNNBQTqGqjNUNO0BXa92HyfTg7PqZ6mHwvR6eVdRevb0JfqHa-KQIpiXjlGeFTxuFIT5OkEbV-2Sh63SAOCVFJeWVzIVpRk_focs4DSH390JhUuEXwQ3V6g6UD03Mhe1KVF2LknJRlmKldf4fKk8HvbcxQOPz-ZuEs3WCHWJKAzSvTRKsVu6rLfczfbL9L6_sP6_ZX6qdqlU</recordid><startdate>20230605</startdate><enddate>20230605</enddate><creator>Rubal, Cristina</creator><creator>Pereira, Augusto</creator><creator>Sastre, Laura Calles</creator><creator>Pérez-Cejuela, Belén Almoguera</creator><creator>Gámiz, Sofía Herrero</creator><creator>Chaves, Pilar</creator><creator>Medina, Tirso Pérez</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2534-1007</orcidid><orcidid>https://orcid.org/0000-0003-4560-453X</orcidid><orcidid>https://orcid.org/0000-0002-4735-0644</orcidid></search><sort><creationdate>20230605</creationdate><title>Managing Vulvodynia with Central Sensitization: Challenges and Strategies</title><author>Rubal, Cristina ; Pereira, Augusto ; Sastre, Laura Calles ; Pérez-Cejuela, Belén Almoguera ; Gámiz, Sofía Herrero ; Chaves, Pilar ; Medina, Tirso Pérez</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-ec0781dd8d5196c8d6441becb15dcbc7ccb9b4ecb42f6b71985bef242e66bcaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Care and treatment</topic><topic>Chronic fatigue syndrome</topic><topic>Clinical medicine</topic><topic>Clitoris</topic><topic>Complications and side effects</topic><topic>Defecation</topic><topic>Fibromyalgia</topic><topic>Health aspects</topic><topic>Hyperalgesia</topic><topic>Inflammation</topic><topic>Irritable bowel syndrome</topic><topic>Nervous system</topic><topic>Nociception</topic><topic>Obstetrics</topic><topic>Pain</topic><topic>Patients</topic><topic>Peptides</topic><topic>Physical therapy</topic><topic>Prognosis</topic><topic>Restless legs syndrome</topic><topic>Sexual intercourse</topic><topic>Vagina</topic><topic>Vulvodynia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rubal, Cristina</creatorcontrib><creatorcontrib>Pereira, Augusto</creatorcontrib><creatorcontrib>Sastre, Laura Calles</creatorcontrib><creatorcontrib>Pérez-Cejuela, Belén Almoguera</creatorcontrib><creatorcontrib>Gámiz, Sofía Herrero</creatorcontrib><creatorcontrib>Chaves, Pilar</creatorcontrib><creatorcontrib>Medina, Tirso Pérez</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rubal, Cristina</au><au>Pereira, Augusto</au><au>Sastre, Laura Calles</au><au>Pérez-Cejuela, Belén Almoguera</au><au>Gámiz, Sofía Herrero</au><au>Chaves, Pilar</au><au>Medina, Tirso Pérez</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Managing Vulvodynia with Central Sensitization: Challenges and Strategies</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2023-06-05</date><risdate>2023</risdate><volume>12</volume><issue>11</issue><spage>3851</spage><pages>3851-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>: Vulvodynia is defined as a chronic idiopathic vulvar pain condition. This study aimed to investigate the effect of central sensitization on the prognosis of neuromodulator treatment for vulvodynia.
A total of 105 patients with vulvodynia who underwent pelvic mapping pain exploration were included and scored according to the Convergence PP Criteria for pelvic pain and central sensitization. The patients were treated according to chronic pelvic pain guidelines, and their response to treatment was evaluated.
A total of 35 out 105 patients (33%) with vulvodynia had central sensitization, which was associated with comorbidities, dyspareunia, pain with micturition, and pain with defecation. Dyspareunia and pain with defecation were independent prognostic factors for central sensitization. Patients with central sensitization experienced more pain during intercourse, urination, or defecation, had more comorbidities, and responded worse to treatment. They required more treatment, with a longer response time (over 2 months). Patients with localized vulvodynia were treated with physiotherapy and lidocaine, while patients with generalized vulvodynia were treated with neuromodulators. Amitriptyline was effective in treating patients with generalized spontaneous vulvodynia and dyspareunia.
Overall, this study highlights the importance of considering central sensitization in the diagnosis and treatment of vulvodynia and the need for individualized treatment based on the patient's symptoms and underlying mechanisms. Vulvodynia patients with central sensitization had more pain during intercourse, urination, or defecation, and responded worse to treatment, requiring more time and medication.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37298046</pmid><doi>10.3390/jcm12113851</doi><orcidid>https://orcid.org/0000-0003-2534-1007</orcidid><orcidid>https://orcid.org/0000-0003-4560-453X</orcidid><orcidid>https://orcid.org/0000-0002-4735-0644</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Care and treatment Chronic fatigue syndrome Clinical medicine Clitoris Complications and side effects Defecation Fibromyalgia Health aspects Hyperalgesia Inflammation Irritable bowel syndrome Nervous system Nociception Obstetrics Pain Patients Peptides Physical therapy Prognosis Restless legs syndrome Sexual intercourse Vagina Vulvodynia |
| title | Managing Vulvodynia with Central Sensitization: Challenges and Strategies |
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