[Perineoplasty for vulvar vestibulitis]

28 premenopausal women with severe dyspareunia were diagnosed as having vulvar vestibulitis. A modified perineoplasty, consisting of removal of the vestibule and exteriorization of the vagina to cover the denuded area and to relax a tight perineum, was performed. 70% of 26 women with adequate follow-up experienced significant relief of vulvar discomfort. In young women with dyspareunia, vestibulitis may be a significant, remediable, causative factor.