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Urethral pressure variation in women with vulvar vestibulitis syndrome
D C Foster1, J C Robinson, K M Davis
1Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Objectives:
It is hypothesized that patients with vulvar vestibulitis syndrome will demonstrate increased urethral pressure variability.
Study Design:
Twelve patients with confirmed vulvar vestibulitis syndrome were compared with two groups: 13 patients with chronic pelvic pain matched for age and race and 23 asymptomatic unmatched patients. Urodynamic variables studied included maximum urethral pressure, functional urethral length, bladder capacity, and urethral pressure variability. During urethral pressure measurement each patient was given a standard mental exercise.
Results:
Urethral pressure variability was significantly greater in patients with vulvar vestibulitis than in those with chronic pain or in asymptomatic controls (Wilcoxon test, p < 0.001). Use of a multiple regression model that controlled for age, race, and parity showed that diagnostic group predicted a significant degree of urethral pressure variability (F = 8.18, p < 0.001).
Conclusions:
Vulvar vestibulitis syndrome is associated with increased urethral pressure variability, and variation in muscular tone of the urethra is the probable source of this variability. However, the possible relationship with the pathogenesis of vulvar vestibulitis syndrome is unknown at present.