May 29th, 2022

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Title:
Diagnosis and Treatment of Vulvodynia
Authors:  Graeme J. Dennerstein, F.R.C.O.G., F.R.A.N.Z.C.O.G.
  To the Editors:
Reed et al1 have highlighted the confusion surrounding the term vulvodynia. No amount of subclassification will alter the fact that vulvodynia
(= vulvar pain) is a symptom, not a diagnosis. Until it finds its appropriate place alongside analogous terms like leukorrhea, nonspecific vaginitis and leukoplakia, vulvodynia will be useful only as a resource for those not performing appropriate laboratory and psychosexual investigation and an excuse for empirical treatment.
A substantial proportion of vulvovaginal complaints can present the most experienced clinician with a management challenge, possibly more so in diagnosis than treatment. At the Dermogynaecology Clinic at the Mercy Hospital for Women, a Melbourne University tertiary referral clinic, after a lengthy, multidisciplinary diagnostic workup, all patients‘ diagnoses were coded according to SNOMED.2 We found that about one third of the patients had more than 1 diagnosis (unpublished data). Vulvodynia was not in our edition of SNOMED and was not missed. Based partly on the experience gained in that clinic, the Vulva and Vagina Manual3 has vulvodynia as a mode of presentation, where it rightfully belongs, together with ìburning/pain/stinging/discomfort other than pruritus,î a group associated with 58 diagnoses.
Keywords:  vulvodynia, diagnosis
   
   
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