Remission of vulvar pain among women with primary vulvodynia.
Remission of vulvar pain among women with primary vulvodynia.
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DOI：
10.1097/lgt.0000000000000041
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发表时间：
2015-01
影响因子：
3.7
通讯作者：
Harlow BL
中科院分区：
文献类型：
--
作者：
Nguyen RH;Mathur C;Wynings EM;Williams DA;Harlow BL
To determine whether rates of remission differed among women with primary versus secondary vulvodynia. Using a community-based observational study based in Minneapolis/St. Paul, 138 clinically-confirmed cases of vulvodynia between 18 – 40 years old were classified as primary (vulvar pain starting at the time of sexual debut or first tampon insertion) or secondary (vulvar pain starting after a time period of pain-free intercourse), and queried regarding their pain history to determine whether they had ever experienced any vulvar pain-free time (remission), or pain-free time lasting ≥3 months. Remission prevalence was 26% (9/34) for women in the shortest quartile of duration of vulvar pain (<3.8 yrs), and 38% (13/34) for the longest quartile of duration (≥13 yrs). After adjusting for vulvar pain duration, generalized vestibular pain, medical treatment, body mass index (BMI), and history of pregnancy, women who had primary vulvodynia were 43% less likely to report remission (95% CI: 0.33 – 0.99) than women with later onset (secondary cases). The association was strengthened when restricting to only remissions lasting ≥3 months (adj. RR=0.43, 95% CI: 0.22 – 0.84). Generalized vestibulodynia and obesity also reduced the likelihood of remission. Our study underscores the heterogeneity of vulvodynia and provides evidence that primary vulvodynia may have a less wavering course, and as such, a potentially different underlying mechanism than that of secondary vulvodynia.
