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[PMID]: 28970071
[Au] Autor:Lev-Sagie A; Kopitman A; Brzezinski A
[Ad] Address:Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel. Electronic address: levsagie@netvision.net.il.
[Ti] Title:Low-Level Laser Therapy for the Treatment of Provoked Vestibulodynia-A Randomized, Placebo-Controlled Pilot Trial.
[So] Source:J Sex Med;14(11):1403-1411, 2017 Nov.
[Is] ISSN:1743-6109
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Low-level laser therapy (LLLT) is an emerging medical technology in which non-thermal laser irradiation is applied to treat pain. Because LLLT has been found effective in treating various pain syndromes without known side effects, we conducted a study evaluating the effect of LLLT on provoked vestibulodynia (PVD), a complex sexual pain disorder characterized by pain confined to the vulvar vestibule in response to contact or pressure. AIM: To investigate the effectiveness of LLLT for PVD in a randomized, placebo-controlled, double-blinded trial. METHODS: Patients with PVD were randomly assigned to receive treatment with LLLT or sham treatment. Patients were treated twice weekly for 6 weeks, for a total of 12 LLLT or placebo sessions. Patients who showed improvement after LLLT were followed for 1 year by clinical pain report and Q-tip examination. OUTCOMES: Change in pain scores obtained in response to the Q-tip test, clinical pain report, visual analog scale score, pain with tampon insertion, daily pain intensity, intercourse pain intensity, frequency of intercourse, and a battery of quality-of-life measures. RESULTS: Thirty-four patients with PVD participated, 18 received LLLT and 16 received placebo. In the clinical pain report at study completion, 14 of 18 patients (78%) receiving LLLT reported improvement compared with 7 of 16 (44%) in the placebo group (P = .042). This effect was not apparent in other outcome measurements. None of the patients reported side effects during the study. At 1-year follow-up, eight patients (57%) reported lasting improvement. CLINICAL IMPLICATIONS: Larger studies with various treatment protocols are needed to define which patients can benefit from LLLT therapy. STRENGTHS AND LIMITATIONS: Strengths include a placebo-controlled, double-blinded design, measurement of a large number of multidimensional end points, and a follow-up period of 1 year. Limitations include the small number of patients recruited, no improvement in measurable parameters, a high improvement rate in the placebo group, the absence of use of validated questionnaires, and the lack of evaluation of psychological and interpersonal factors that might have influenced the results. CONCLUSIONS: Given the results of this pilot study, LLLT cannot currently be recommended as a treatment for PVD. Further studies with a larger population, various treatment protocols, and evaluation of LLLT in different subgroups of PVD are needed to define which patients can benefit from this therapy. Lev-Sagie A, Kopitman A, Brzezinski A. Low-Level Laser Therapy for the Treatment of Provoked Vestibulodynia-A Randomized, Placebo-Controlled Pilot Trial. J Sex Med 2017;14:1403-1411.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171107
[Lr] Last revision date:171107
[St] Status:In-Process

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[PMID]: 27312009
[Au] Autor:Falsetta ML; Foster DC; Bonham AD; Phipps RP
[Ad] Address:Department of Environmental Medicine, University of Rochester, Rochester, NY, USA.
[Ti] Title:A review of the available clinical therapies for vulvodynia management and new data implicating proinflammatory mediators in pain elicitation.
[So] Source:BJOG;124(2):210-218, 2017 Jan.
[Is] ISSN:1471-0528
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Localised provoked vulvodynia (LPV) is a common, chronic, and disabling condition: patients experience profound pain and a diminished quality of life. The aetiologic origins of vulvodynia are poorly understood, yet recent evidence suggests a link to site-specific inflammatory responses. Fibroblasts isolated from the vestibule of LPV patients are sensitive to proinflammatory stimuli and copiously produce pain-associated proinflammatory mediators (IL-6 and PGE ). Although LPV is a multifactorial disorder, understanding vulvar inflammation and targeting the inflammatory response should lead to treatment advances, especially for patients exhibiting signs of inflammation. NFκB (already targeted clinically) or other inflammatory components may be suitable therapeutic targets. TWEETABLE ABSTRACT: Vulvodynia is a poorly understood, prevalent, and serious women's health issue requiring better understanding to improve therapy.
[Pt] Publication type:REVIEW; JOURNAL ARTICLE
[Em] Entry month:1606
[Cu] Class update date: 170224
[Lr] Last revision date:170224
[St] Status:In-Data-Review
[do] DOI:10.1111/1471-0528.14157

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[PMID]: 27838536
[Au] Autor:Murina F; Graziottin A; Felice R; Di Francesco S
[Ad] Address:Lower Genital Tract Disease Unit, V. Buzzi Hospital-University of Milan, Milan, Italy. Electronic address: filippomurina@tin.it.
[Ti] Title:Coital pain in the elderly: could a low dose estriol gel thrill the vulvar vestibule?
[So] Source:Eur J Obstet Gynecol Reprod Biol;207:121-124, 2016 Dec.
[Is] ISSN:1872-7654
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The aim of this study was to evaluate the effectiveness of the application of 0.005% estriol gel to the vulvar vestibule in the management of postmenopausal dyspareunia. STUDY DESIGN: Postmenopausal women with dyspareunia were enrolled in this study. Patients were instructed to use a fingertip to apply 0.25g of vaginal gel containing 25µg of estriol to the vulvar vestibule daily for three weeks and then twice weekly for up to 12 weeks. RESULTS: Assessment of symptoms (dyspareunia and cotton swab test) and signs of vestibular atrophy were performed, and changes between baseline and weeks 3 and 12 were assessed. Adverse events were recorded. A total of 63 women were included. Of the 63, 59 (93.6%) completed the 12-week treatment period, and four dropped out for vestibular burning. Dyspareunia improved or was cured (score ≤1) by week 12 in 81.4% of patients. The patients also showed a statistically significant reduction in vestibular atrophy and cotton swab test at the end of treatment. CONCLUSIONS: Application of 0.005% estriol gel to the vulvar vestibule is effective in correcting menopausal coital pain. This suggests that reduction in sensory vestibular innervation sensitivity is likely to play a pivotal role in the relief of dyspareunia. One limitation of this study is the limited follow-up, but the therapy may be continued for as long as the patients are distressed by their symptoms without estrogen intervention.
[Mh] MeSH terms primary: Aging
Dyspareunia/prevention & control
Estriol/administration & dosage
Estrogens/administration & dosage
Vulvar Vestibulitis/drug therapy
Vulvodynia/prevention & control
[Mh] MeSH terms secundary: Aged
Atrophy
Drug Administration Schedule
Dyspareunia/etiology
Estriol/adverse effects
Estriol/therapeutic use
Estrogens/adverse effects
Estrogens/therapeutic use
Female
Gels
Humans
Italy
Middle Aged
Pain/chemically induced
Pain Measurement
Patient Dropouts
Postmenopause
Severity of Illness Index
Vaginal Creams, Foams, and Jellies/administration & dosage
Vaginal Creams, Foams, and Jellies/adverse effects
Vaginal Creams, Foams, and Jellies/therapeutic use
Vulva
Vulvar Vestibulitis/immunology
Vulvar Vestibulitis/pathology
Vulvar Vestibulitis/physiopathology
Vulvodynia/etiology
[Pt] Publication type:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Name of substance:0 (Estrogens); 0 (Gels); 0 (Vaginal Creams, Foams, and Jellies); FB33469R8E (Estriol)
[Em] Entry month:1707
[Cu] Class update date: 170704
[Lr] Last revision date:170704
[Js] Journal subset:IM
[Da] Date of entry for processing:161114
[St] Status:MEDLINE

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[PMID]: 27568225
[Au] Autor:Kliethermes CJ; Shah M; Hoffstetter S; Gavard JA; Steele A
[Ad] Address:Department of Obstetrics and Gynecology, St. Louis University, St. Louis, Missouri. Electronic address: ckliethe@gmail.com.
[Ti] Title:Effect of Vestibulectomy for Intractable Vulvodynia.
[So] Source:J Minim Invasive Gynecol;23(7):1152-1157, 2016 Nov - Dec.
[Is] ISSN:1553-4669
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:STUDY OBJECTIVE: To assess the effectiveness of vestibulectomy in treating vulvodynia for patients with inadequate response to vulvar care guidelines and medical management. DESIGN: Retrospective case series (Canadian Task Force classification II-2). PATIENTS: All patients who underwent a vestibulectomy from 2004 to 2013 for vulvodynia. INTERVENTIONS: All patients in this study underwent a vestibulectomy. MEASUREMENTS AND MAIN RESULTS: In this study we analyzed 31 patients' overall reported pain scores and Q-tip test scores before and after vestibulectomy. The efficacy of vestibulectomy on reduction of pain was then analyzed after surgical management. There was no significant difference in pain scores from initial visit compared with the last visit before vestibulectomy after vulvar care guidelines and medical management were initiated (p = .48-.94). However, mean subjective pain scores before and after vestibulectomy decreased by 67% (p < .001). Q-tip testing showed reductions of pain by 63% (p < .001) and 73% (p < .001) at the right and left Bartholin gland areas, respectively. There was approximately a 60% decrease of pain scored around the bilateral periurethral areas (p < .05). CONCLUSIONS: Vestibulectomy is an effective treatment for vulvodynia. For those with intractable pain, vestibulectomy is an appropriate next step after unsuccessful medical treatment. The surgery leads to a significant decrease in patients' pain scores, nearly eliminating it in most cases.
[Mh] MeSH terms primary: Vulvar Vestibulitis/surgery
Vulvodynia/surgery
[Mh] MeSH terms secundary: Adult
Aged
Female
Gynecologic Surgical Procedures
Humans
Middle Aged
Missouri
Pain Measurement
Pain, Intractable
Retrospective Studies
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170713
[Lr] Last revision date:170713
[Js] Journal subset:IM
[Da] Date of entry for processing:160829
[St] Status:MEDLINE

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[PMID]: 27530381
[Au] Autor:Burke YZ; Lowenstein L
[Ad] Address:Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: yechielb@gmail.com.
[Ti] Title:Value of Quantitative Sensory Testing in the Evaluation of Genital Sensation: Its Application to Female Sexual Dysfunction.
[So] Source:Sex Med Rev;4(2):121-5, 2016 Apr.
[Is] ISSN:2050-0521
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Female sexual dysfunction (FSD) is multifactorial, with psychological and organic elements. Genital sensation, an important component of sexual response, has until recently not been subjected to adequate clinical appraisal. During the past 15 years we have performed Quantitative Sensory Testing (QST) to assess genital sensation in healthy women and women with FSD. AIM: To review available evidence of QST in the investigation of genital sensation in women with FSD. METHODS: We examined data obtained from assessment of genital sensation in normal women and those with different conditions, including multiple sclerosis, pelvic floor disorders, effect of hysterectomy, and vulvar vestibulitis. MAIN OUTCOME MEASURE: Use of QST for assessment of FSD. RESULTS: Normograms for healthy women were used to measure parameters during arousal, orgasm, and the refractory phase. Using QST, genital sensation was found to be impaired in women with multiple sclerosis. Clitoral vibratory sensation most significantly correlated with FSD parameters. Women with greater deficit in vibratory sensation encountered more sexual dysfunction. Women with urinary incontinence had a significant decrease in sensitivity to warm, cold, and vibratory thresholds in the anterior vaginal wall and clitoral area. A study comparing women with and without pelvic organ prolapse showed mean thresholds for vibratory and warm stimuli to be significantly higher and mean thresholds for cold stimuli to be significantly lower in the group with prolapse. QST of women undergoing hysterectomy showed a significant decrease in sensation to cold, warm, and vibratory stimuli at the anterior and posterior vaginal wall; clitoral thermal and vibratory sensation thresholds remained unchanged after surgery. In a study of vulvar vestibulitis, patients reported significantly lower heat pain thresholds compared with controls. CONCLUSION: QST appears useful for evaluating various gynecologic disorders associated with disturbed sexual function and with multiple sclerosis, which might be accompanied by disturbed genital sensation.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1608
[Cu] Class update date: 160817
[Lr] Last revision date:160817
[Js] Journal subset:IM
[St] Status:In-Data-Review

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[PMID]: 27457118
[Au] Autor:Tommola P; Unkila-Kallio L; Paetau A; Meri S; Kalso E; Paavonen J
[Ad] Address:Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: paivi.tommola@kolumbus.fi.
[Ti] Title:Immune activation enhances epithelial nerve growth in provoked vestibulodynia.
[So] Source:Am J Obstet Gynecol;215(6):768.e1-768.e8, 2016 Dec.
[Is] ISSN:1097-6868
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Provoked vestibulodynia manifests as allodynia of the vulvar vestibular mucosa. The exact mechanisms that result in altered pain sensation are unknown. Recently, we demonstrated the presence of secondary lymphoid tissue, which is the vestibule-associated lymphoid tissue in the vestibular mucosa, and showed that this tissue becomes activated in provoked vestibulodynia. OBJECTIVE: The purpose of this study was to examine whether expression of intraepithelial nerve fibers and nerve growth factor are related to immune activation in provoked vestibulodynia. STUDY DESIGN: Vestibular mucosal specimens were obtained from 27 patients with severe provoked vestibulodynia that was treated by vestibulectomy and from 15 control subjects. We used antibodies against the protein gene product 9.5, the neuron specific neurofilament, and nerve growth factor for immunohistochemistry to detect intraepithelial nerve fibers and nerve growth factor expressing immune cells in the vestibular mucosa. For intraepithelial nerve fibers, we determined their linear density (fiber counts per millimeter of the outer epithelial surface, protein gene product 9.5) or presence (neuron specific neurofilament). Nerve growth factor was analyzed by counting the staining-positive immune cells. Antibodies against CD20 (B lymphocytes) and CD3 (T lymphocytes) were used to identify and locate mucosal areas with increased density of lymphocytes and the presence of germinal centers (ie, signs of immune activation). B-cell activation index was used to describe the overall intensity of B-cell infiltration. RESULTS: We found more protein gene product 9.5-positive intraepithelial fibers in vestibulodynia than in the control samples (6.3/mm [range, 0.0-15.8] vs 2.0/mm [range, 0.0-12.0]; P=.006). Neuron specific neurofilament -positive intraepithelial fibers were found in 17 of 27 vestibulodynia cases (63.0%) and in none of the control cases. Protein gene product 9.5-positive intraepithelial fibers were more common in samples with more pronounced immune activation. The density of these fibers was higher in samples with than without germinal centers (6.1/mm [range, 4.3-15.8] vs 3.0/mm [range, 0.0-13.4]; P=.020). A positive correlation between the fiber density and B-cell activation index score of the sample was found (Spearman's Rho, 0.400; P=.004; R =0.128). No significant difference, however, was found in the density or presence of nerve fibers between samples with high and low T-cell densities. We identified areas of minor and major vestibular glands in 16 of the patient samples and in 1 control sample. Protein gene product 9.5-positive nerve fibers were found more often in glandular epithelium surrounded by B-cell infiltration than in glands without B cells (P=.013). Also, the presence of neuron specific neurofilament-positive fibers in glandular epithelium was associated with B-cell infiltrates (P=.053). Nerve growth factor-positive immune cells were more common in mucosal areas with than without B-cell infiltration and intraepithelial nerve fibers. CONCLUSION: Excessive epithelial nerve growth in provoked vestibulodynia is associated with increased B-cell infiltration and the presence of germinal centers. This supports the fundamental role of immune activation in provoked vestibulodynia.
[Mh] MeSH terms primary: Epithelium/immunology
Lymphoid Tissue/immunology
Mucous Membrane/immunology
Nerve Fibers/immunology
Nerve Growth Factor/immunology
Vulvodynia/immunology
[Mh] MeSH terms secundary: Adolescent
Adult
Case-Control Studies
Epithelium/innervation
Epithelium/metabolism
Epithelium/pathology
Female
Humans
Immunohistochemistry
Lymphoid Tissue/metabolism
Middle Aged
Mucous Membrane/innervation
Mucous Membrane/metabolism
Mucous Membrane/pathology
Nerve Fibers/pathology
Nerve Growth Factor/metabolism
Vulva/immunology
Vulva/innervation
Vulva/metabolism
Vulva/pathology
Vulvodynia/metabolism
Vulvodynia/pathology
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:9061-61-4 (Nerve Growth Factor)
[Em] Entry month:1705
[Cu] Class update date: 170531
[Lr] Last revision date:170531
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:160727
[St] Status:MEDLINE

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[PMID]: 27045260
[Au] Autor:Bornstein J; Goldstein AT; Stockdale CK; Bergeron S; Pukall C; Zolnoun D; Coady D; consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD); International Society for the Study of Women's Sexual Health (ISSWSH); International Pelvic Pain Society (IPPS)
[Ad] Address:Department of Obstetrics & Gynecology, Galilee Medical Center and Bar Ilan Faculty of Medicine, Nahariya, Israel. Electronic address: mdjacob@gmail.com.
[Ti] Title:2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia.
[So] Source:J Sex Med;13(4):607-12, 2016 Apr.
[Is] ISSN:1743-6109
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: In 2014, the Executive Council of the International Society for the Study of Vulvovaginal Disease (ISSVD), the Boards of Directors of the International Society for the Study of Women's Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) acknowledged the need to revise the current terminology of vulvar pain, based on the significant increase in high quality etiologic studies published in the last decade. METHODS: The new terminology was achieved in four steps. The first involved a terminology consensus conference with representatives of the three societies, held in April 2015. Then, an analysis of the relevant published studies was used to establish a level of evidence for each factor associated with vulvodynia. The terminology was amended based on feedback from members of the societies. Finally, each society's board accepted the new terminology. RESULTS AND CONCLUSION: In 2015, the ISSVD, ISSWSH, and IPPS adopted a new vulvar pain and vulvodynia terminology that acknowledges the complexity of the clinical presentation and pathophysiology involved in vulvar pain and vulvodynia, and incorporates new information derived from evidence-based studies conducted since the last terminology published in 2003.
[Mh] MeSH terms primary: Consensus
Vulvodynia/classification
[Mh] MeSH terms secundary: Female
Humans
Reproductive Health
Sexual Behavior
Societies, Medical
Terminology as Topic
Women's Health
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1609
[Cu] Class update date: 160406
[Lr] Last revision date:160406
[Js] Journal subset:IM
[Da] Date of entry for processing:160406
[St] Status:MEDLINE

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[PMID]: 27040422
[Au] Autor:Theodoropoulos DS; Stockdale CK; Duquette DR; Morris MS
[Ad] Address:Allergy Associates of La Crosse, 2727 Midwest Drive, Onalaska, WI, 54650, USA. dtheodoropoulos@allergy-solutions.com.
[Ti] Title:Inhalant allergy compounding the chronic vaginitis syndrome: characterization of sensitization patterns, comorbidities and responses to sublingual immunotherapy.
[So] Source:Arch Gynecol Obstet;294(3):541-8, 2016 Sep.
[Is] ISSN:1432-0711
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To characterize sensitization patterns, diagnoses and comorbidities, and to assess the response of lower genital tract symptoms to sublingual immunotherapy for airborne allergens in a select population of patients with chronic vaginitis. METHODS: Fifty-two patients referred for allergy evaluation over a 44 month period were studied. Charts were retrospectively reviewed to establish: (1) gynecological diagnoses, (2) allergic-immunological diagnoses, and (3) IgE-mediated sensitivity to airborne allergens on presentation. Patients were contacted at 9-50 months of treatment to assess response to sublingual immunotherapy based on a questionnaire addressing frequency and severity of symptoms and use of medication to control symptoms. RESULTS: Recurrent vulvovaginal candidiasis was identified in 34 (65 %); vulvar vestibulitis syndrome in 12 (23 %); and contact dermatitis in 10 (19 %) patients. Comorbidities included: non-reflux gastrointestinal complaints in 11 (21 %), gastroesophageal reflux in 5 (9 %), migraines in 9 (17 %), chronic non-migrainous headaches in 8 (17 %), and chronic sinusitis in 6 patients (11 %). Asthma was diagnosed in 8 patients (15 %). Oral allergy syndrome was present in 6 (11 %). Most frequent sensitivities were to: ragweed in 33 (63 %), molds in 26 (50 %), dust mites in 23 (44 %), and grass in 12 (23 %) patients. Mono-sensitization was demonstrated for ragweed in 7 (13 %), and for molds, dust mites and grass for 3 (5 %) patients each. Candida sensitization was identified in 15 patients with chronic vaginitis (28 %). Eleven patients with recurrent vulvovaginal diagnosis (32 %) showed Candida sensitization. Response to immunotherapy was generally favorable with pruritus/irritation being more responsive than visceral pain. CONCLUSIONS: In a Midwestern referral population, chronic vaginitis compounded by inhalant allergy showed: (1) high incidence rate of recurrent vulvo-vaginal candidiasis, (2) Candida IgE-mediated sensitization in less than one-third of patients with recurrent vulvovaginal candidiasis, (3) comorbid conditions not dissimilar to those of other allergic patients, and (4) allergen sensitization pattern typical for the Midwest.
[Mh] MeSH terms primary: Allergens/immunology
Sublingual Immunotherapy
Vaginitis/immunology
[Mh] MeSH terms secundary: Adult
Chronic Disease
Comorbidity
Female
Humans
Immunoglobulin E/immunology
Retrospective Studies
Syndrome
Vaginitis/etiology
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Allergens); 37341-29-0 (Immunoglobulin E)
[Em] Entry month:1709
[Cu] Class update date: 170919
[Lr] Last revision date:170919
[Js] Journal subset:IM
[Da] Date of entry for processing:160405
[St] Status:MEDLINE
[do] DOI:10.1007/s00404-016-4081-2

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[PMID]: 26407563
[Au] Autor:Champaneria R; D'Andrea RM; Latthe PM
[Ad] Address:Birmingham Clinical Trials Unit, College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. r.champaneria@bham.ac.uk.
[Ti] Title:Hormonal contraception and pelvic floor function: a systematic review.
[So] Source:Int Urogynecol J;27(5):709-22, 2016 May.
[Is] ISSN:1433-3023
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION AND HYPOTHESIS: Hormonal contraceptive use is common practice worldwide. Although the effects of hormone treatments in the pelvic region are well established, there is no clear evidence regarding their effects on incontinence, bladder, bowel, vaginal and sexual symptoms in premenopausal women. We hypothesized that hormonal contraceptives affect pelvic floor function. We therefore performed a comprehensive systematic review of published studies to determine the influence of hormonal contraception on pelvic floor functions. METHODS: Electronic literature databases were searched from database inception to March 2015. Keywords and medical subject headings searched for included terms and word variations for 'contraception', and 'bowel', 'vaginal', 'sexual' and 'urinary' symptoms. Studies were eligible if they looked at these symptoms in women taking hormonal contraception. Two reviewers independently screened studies for inclusion, and extracted data on study characteristics, quality and results. Data were combined where possible. RESULTS: Of the 429 citations identified, 13 studies were included in the review. Data were meta-analysed where possible and presented as prevalence. The results indicate statistically significant links between interstitial cystitis and oral contraceptive use at any point (ever) (OR 2.31, 95 % CI 1.03 - 5.16; p = 0.04) and vulvar vestibulitis and current oral contraceptive use (OR 2.10, 95 % CI 1.26 - 3.49; p = 0.004). The evidence is unclear in other areas. CONCLUSIONS: Our results indicate that oral contraceptives may have an effect on pelvic floor function. They could increase the risk of painful bladder and vulvar vestibulitis, but their effect on dyspareunia is inconsistent. However, robustly collected prospective data to establish causal associations are needed.
[Mh] MeSH terms primary: Contraceptive Agents, Female/therapeutic use
Cystitis, Interstitial/epidemiology
Intrauterine Devices, Medicated
Levonorgestrel/therapeutic use
Lower Urinary Tract Symptoms/epidemiology
[Mh] MeSH terms secundary: Contraceptives, Oral, Hormonal/therapeutic use
Delayed-Action Preparations/therapeutic use
Dyspareunia/epidemiology
Female
Humans
Medroxyprogesterone Acetate/therapeutic use
Pelvic Floor/physiopathology
Premenopause
Vulvodynia/epidemiology
[Pt] Publication type:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Name of substance:0 (Contraceptive Agents, Female); 0 (Contraceptives, Oral, Hormonal); 0 (Delayed-Action Preparations); 5W7SIA7YZW (Levonorgestrel); C2QI4IOI2G (Medroxyprogesterone Acetate)
[Em] Entry month:1701
[Cu] Class update date: 170920
[Lr] Last revision date:170920
[Js] Journal subset:IM
[Da] Date of entry for processing:150927
[St] Status:MEDLINE
[do] DOI:10.1007/s00192-015-2833-3

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[PMID]: 26650698
[Au] Autor:Ben-Aroya Z; Edwards L
[Ad] Address:Vulva & Cervix Clinic, Maccabi Health Services, Rehovot, Israel.
[Ti] Title:Vulvodynia.
[So] Source:Semin Cutan Med Surg;34(4):192-8, 2015 Dec.
[Is] ISSN:1085-5629
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Vulvodynia is a pain syndrome affecting the vulva. It occurs in about 16% of women at some time of their lives. The etiology of vulvodynia is still enigmatic and is probably multifactorial-including physiological concerns (eg, pelvic floor muscle dysfunction, neuropathic pain, and psychosocial) and sexual issues (eg, anxiety and sexual dysfunction). Although it is a common syndrome, most patients are neither correctly diagnosed nor treated. A diagnosis of vulvodynia is based upon patient history and lack of physical findings upon careful examination. No clinical or histological findings are present to aid in diagnosis. Most treatment options for vulvodynia are neither well studied nor have an evidence base, relying instead upon expert opinion, care provider experience, and use of data from other pain syndromes. However, many patients show marked improvement after physical therapy for the pelvic floor, medications for neuropathic pain, and psychosexual therapy.
[Mh] MeSH terms primary: Disease Management
Vulvodynia
[Mh] MeSH terms secundary: Diagnosis, Differential
Female
Global Health
Humans
Incidence
Vulvodynia/diagnosis
Vulvodynia/epidemiology
Vulvodynia/therapy
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1602
[Cu] Class update date: 160115
[Lr] Last revision date:160115
[Js] Journal subset:IM
[Da] Date of entry for processing:151210
[St] Status:MEDLINE
[do] DOI:10.12788/j.sder.2015.0181


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