By Alessandra Graziottin MD, Filippo Murina MD (auth.)
Chronic vulvar ache, or ‘vulvodynia’, is a standard challenge which may have a substantial influence at the health of sufferers. regardless of being obvious in many instances in daily scientific perform, it is still a overlooked sickness that can take decades to diagnose.
This ebook eases the way in which for physicians, together with basic Practitioners and Gynecologists, who're influenced to enhance the lives of ladies struggling with vulvodynia.
By providing a concise review of the newest info at the prognosis and administration of vulvodynia, and its quite a few comorbidities, in a simple to learn, ‘tips and methods’ layout, the e-book empowers physicians to speedily and successfully deal with the advanced and delicate matters surrounding the disorder.
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Extra resources for Clinical Management of Vulvodynia: Tips and Tricks
Box 1. Vulvar pain ● ● ● ● Vulvar pain is often described as having a burning quality Other patients describe their problem as “irritation”, “stinging”, “raw feelings”, “crawling”, or just “vulvar awareness” Discomfort has also been referred to as “the pain down there” or as “feminine pain” Vulvar pain can be: - provoked: it occurs in response to stimulation - unprovoked: it occurs independently of stimulation Clinical Management of Vulvodynia. Alessandra Graziottin, Filippo Murina © Springer-Verlag Italia 2011 35 Clinical Management of Vulvodynia 36 5 Dyspareunia is genital pain experienced just before, during or after sexual intercourse.
The leading opinion indicates that vulvar pain can produce spasm of the levator ani muscle, and pelvic floor hypertonicity contributes to self-maintenance of pain. In summary, the levator ani muscles are innervated by the levator ani nerve, while no evidence of innervation by the pudendal nerve can be found. The levator ani motor neurons are diffusely distributed in the sacral ventral horn, while the pudendal motor neurons are concentrated in Onuf ’s nucleus (a group of neurons located in the ventral part of laminae IX of the anterior horn; see Fig.
In our opinion a different subtype of vestibulodynia exists that is distinguishable by certain characteristics such as trigger factors, age, pelvic floor dysfunction and comorbidities, rather than two diseases classified upon the vulvar symptoms localization and characteristics of pain (provoked or unprovoked). What Is the Role of Pelvic Floor Dysfunction? Electromyographic studies of the pelvic floor in women with unprovoked pain have shown differences compared with asymptomatic patients. Pelvic floor hypertonic dysfunction is found in 80% to 90% of patients with vulvodynia.
Clinical Management of Vulvodynia: Tips and Tricks by Alessandra Graziottin MD, Filippo Murina MD (auth.)