May 28th, 2018

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Localized Provoked Vestibulodynia: Outcomes After Modified Vestibulectomy
Authors:  Casey L. Swanson, PA-C, Jdee A. Rueter, R.N., Janet E. Olson, Ph.D., Amy L. Weaver, M.S., and C. Robert Stanhope, M.D.
  OBJECTIVE: To describe and estimate both short-term and long-term effectiveness of a large cohort of women treated with modified vestibulectomy in a single surgical service.

STUDY DESIGN: A total of 202 patients who were treated with modified vestibulectomy for localized provoked vestibulodynia at Mayo Clinic in Rochester, Minnesota, were mailed a questionnaire to document severity of vulvar pain or discomfort before and after the surgery.

RESULTS: In total, 115 patients returned the questionnaire. Of the 71 patients who before surgery reported pain when inserting a tampon, 52 reported attempting to insert a tampon after surgery. Of these 52 patients, 47 (90.4%) noticed moderate to substantial improvement. Pain with sexual intercourse occurred in 97.3% (107/ 110) of patients before surgery. After surgery, 90 (84.1%) of those 107 patients noted moderate to substantial improvement in their pain with intercourse.

CONCLUSION: Modified vestibulectomy was a successful treatment for patients with localized provoked vestibulodynia and resulted in strong patient satisfaction, long-term effectiveness, minimal scarring, and few postoperative complications.
Keywords:  dyspareunia, vestibulectomy, vestibulodynia, vulva, vulvar dysesthesia localized in the vestibule, vulvar pain
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