June 18th, 2018

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Assessing Severity of Pain in Women with Focal Provoked Vulvodynia: Are von Frey Filaments Suitable Devices?
Authors:  Gilbert G. G. Donders, M.D., Ph.D., and Gert Bellen, R.N.
  OBJECTIVE: To determine whether von Frey filaments are effective in the standardized assessment of the severity of focal provoked vulvodynia (FPV) syndrome.

STUDY DESIGN: The data of 30 women with FPV attending monthly at our vulvovaginal disease clinic, for a collective total of 141 visits over 6 months, were analyzed. At each visit sensitivity tests at the vulvar vestibule were performed at the 5 and 7 o’clock area, totaling 282 measurements. A questionnaire, blinded to the examining physician, and a visual analogue score (VAS) of pain ranging from 1 (no pain) to 10 (maximal pain) was obtained of the discomfort felt when attempting sexual intercourse.

RESULTS: The VAS, the investigator assessment of redness, and the 1 to 10 score result of the cotton swab touch test at 5 and 7 o’clock were superior diagnostic tools for assessing the severity of the pain when compared to the use of von Frey filaments.

CONCLUSION: Although elegant because of the promise of objective, semiquantitative measurements, von Frey filaments are less suitable devices to assess severity of disease and response to treatment than are cotton swab 1 to 10 pain scores and clinical parameters like subjective pain (VAS) and objective focal redness.
Keywords:  dyspareunia; sexual dysfunction, physiological; sexual intercourse; von Frey filaments; vulvodynia; vulvar vestibulitis syndrome
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