IngentaConnect Vulvodynia: The Challenge of "Unexplained" Genital Pain

Authors: Graziottin, Alessandra¹; Castoldi, Elena²; Montorsi, Francesco³; Salonia, Andrea³; Maga, Tommaso³

Source: Journal of Sex and Marital Therapy, Volume 27, Number 5, 1 October 2001 , pp. 503-512(10)

Publisher: Routledge, part of the Taylor & Francis Group

Abstract:

Vulvodynia is a clinical syndrome that may include unexplained vulvar pain, sexual dysfunction, and psychological disability. It is a multifactorial syndrome that should be diagnosed, if possible, with an intradisciplinary approach. This article discusses the diagnosis and treatment of vulvodynia, starting with a summary of the complex nervous system within the pelvis. Different clinical pictures and different subtypes of the syndrome have been described in order to identify the etiologic aspects that are essential for diagnosis and subsequent treatment. Clinical evalaution should stress attention to detailed "pain-mapping" and evaluation of past and present history. The gynecological examination should be an overall patient evaluation, incorporating global physical impression, change in posture due to pain and careful examination of the pelvic floor. Examination of the pelvic floor is frequently omitted. Leading to an incorrect diagnosis of psychogenic pain. Such a misdiagnosis can result in the dismissal of appropriate treatment. Proper evaluation requires a comprehensive, multidisciplinary approach that includes medical, rehabilitative, and psychological issues.

Document Type: Research article

DOI: 10.1080/009262301753454027

Affiliations: 1: Department of Gynecology, Center of Medical Sexology, Hospital San Raffaele, Rome, Italy 2: Center of Medical Sexology and Gynecology, Hopsital San Raffaele Eur, Rome, Italy 3: Department of Urology, Hospital San Raffaele, Milan, Italy

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