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Vulvar vestibulitis syndrome (VVS), ... Treatment typically requires a multidisciplinary team including a gynecologist, a pelvic floor physical therapist, sometimes a ...
A vestibulectomy is a gynecological surgical procedure that can be used to treat vulvar pain, specifically in cases of provoked vestibulodynia. Vestibulodynia (vulvar vestibulitis) is a chronic pain syndrome that is a subtype of localized vulvodynia [1] where chronic pain and irritation is present in the vulval vestibule, which is near the entrance of the vagina. [2]
Initiation of hormonal contraceptives that contain low- dose estrogen before the age of 16 could predispose women to vulvar vestibulitis syndrome. A significantly lower pain threshold, especially in the posterior vestibulum, has also been associated with the use of hormonal contraceptives in women without vulvar vestibulitis syndrome. [15]
Perineoplasty is generally considered effective for treatment of dyspareunia, [6] including that caused by lichen sclerosus, [7] and vaginismus. [6] It is also considered an effective treatment for vulvar vestibulitis, although it is generally recommended following the failure of nonsurgical methods. [8] [9] [10]
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Localized provoked vulvodynia is the most recent terminology for what used to be called vulvar vestibulitis when the pain is localized to the vaginal opening. Conditions that affect the surface of the vulva including LSEA (lichen sclerosus et atrophicus), or xerosis (dryness, especially after the menopause).
Vulvar cancer accounts for about 5% of all gynecological cancers and typically affects women in later life. Five-year survival rates in the United States are around 70%. [1] Symptoms of vulvar cancer include itching, a lump or sore on the vulva which does not heal and/or grows larger, and sometimes discomfort/pain/swelling in the vulval area.
Structures opening in the vulval vestibule are the urethra (urinary meatus), vagina, Bartholin's glands, and Skene's glands. [1]The external urethral orifice is placed about 25–30 millimetres (1–1.2 in) [2] behind the clitoris and immediately in front of that of the vagina; it usually assumes the form of a short, sagittal cleft with slightly raised margins.