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[Vulvodynia]
1Institut Alfred Fournier, Paris.
Definition:
Vulvodynia includes a group of vulva disorders in patients with a normal clinical presentation. Chronic and spontaneous complaints are observed, sometimes aggravated by sexual intercourse. Most patients complain of a burning vulva.
Management:
The diagnostic and therapeutic approach to vulvodynia is long and difficult. Complementary explorations may be useful initially but should not be repeated too often. They are helpful in ruling out vulvovaginal infections (candidiasis, sexually transmitted diseases) and vulva dermatosis. Vulvodynia can then be classed as cyclic vulvo-dynia, vestibulitis or essential (dysesthesic vulvodynia).
Multidisciplinary Care:
Each different type of vulvodynia requires specific care. In all cases, the psychosomatic aspect must be considered. Multidisciplinary care may involve the primary care physician, the gynecologist, the dermatologist, the pain specialist, the psychologist, the psychiatrist, and the physical therapy specialist.