Management of Pediatric and Adolescent Vulvodynia: A Retrospective Single Institutional Review

To describe the treatment options, experiences, and outcomes in vulvodynia among pre-pubertal, peri-pubertal, and post-pubertal patients.

A retrospective chart review, primarily descriptive in nature, of female patients aged 0-21 years who presented to the pediatric and adolescent gynecology clinic of a tertiary care hospital with a diagnosis of vulvodynia between January 1, 2015 to August 31, 2022. Patients who were pregnant or diagnosed with other gynecological conditions that could be a source of pain were excluded. Data was summarized using frequencies and proportions for categorical variables and mean and standard deviation for continuous measures.

There were 24 identified patients, 9 (37.5%) of which were pre-pubertal, 6 (25.0%) peri-pubertal, and 9 (37.5%) post-pubertal. The average age at the time of diagnosis was 11.0 ± 4.19 years. Most of the patients were White, accounting for 58.3% of the population, followed by Hispanic at 25.0%. Treatment approach for patients was variable and non-standardized. Success often required use of multiple medications, and no one treatment alone was identified to be the most effective. The most commonly identified burdens of disease were mood and sleep disturbances, and missing school.

Vulvodynia is a disease of variable presentation with individualized treatment plans. No obvious patterns were identified in presentation or treatment response based on pubertal status. More data is needed to determine if a standard of care can be developed in this population. Furthermore, early diagnosis and initiation of treatment may reduce the psychological stress of having a chronic pain condition and improve function.