Self-Reported Vulvar Pain Characteristics and Their Association with Clinically Confirmed Vestibulodynia
Self-Reported Vulvar Pain Characteristics and Their Association with Clinically Confirmed Vestibulodynia
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DOI：
10.1089/jwh.2008.1032
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发表时间：
2009-09-01
影响因子：
3.5
通讯作者：
Duval, Susan J.
中科院分区：
文献类型：
--
作者：
Harlow, Bernard L.;Vazquez, Gabriela;Duval, Susan J.
目的：我们评估了一系列的问题，有关外阴疼痛症状，以确定其与局部外阴痛（vestibulodynia）诊断的妇女从一般population.Methods：一个样本的12,435名妇女完成了自我管理的筛选问卷的存在下，特定类型和特征的外阴疼痛持续3个月或更长时间。以121例临床确诊为前庭痛的受试者作为金标准，计算外阴疼痛类型和特征的每种交叉分类的敏感性、特异性和预测值。相对于临床确诊的前庭痛女性，83%的女性报告在插入阴道、性交或盆腔检查时接触疼痛>10次，83%的人还报告了接触时的疼痛，这限制或阻止了性交。这些与前庭痛诊断的强相关性在报告外阴疼痛症状为烧灼感或刀状疼痛、外阴疼痛特征为连续性与间歇性疼痛、或诱发性与自发性疼痛的女性中没有观察到。我们的研究结果表明，少数症状可能适合于确定大部分女性患有前庭痛，这可能是理想的发展，一个有效的筛选测试。然而，我们也认识到，很大比例的女性经历外阴疼痛症状将不符合前庭痛的诊断标准。因此，作为常规检查或测试的一部分实施这种筛查程序将需要随后的盆腔检查以确认前庭痛诊断并排除外阴疼痛的其他已知解释。
Objective: We evaluated a series of questions pertaining to vulvar pain symptoms to determine their association with a localized vulvodynia (vestibulodynia) diagnosis in women from the general population.Methods: A sample of 12,435 women completed a self-administered screening questionnaire for the presence of specific types and characteristics of vulvar pain lasting 3 months or longer. Sensitivity, specificity, and predictive values were calculated for each cross-classification of vulvar pain type and characteristic, using as the gold standard 121 subjects with a clinically confirmed vestibulodynia diagnosis.Results: Relative to women with clinically confirmed vestibulodynia, 83% reported >10 episodes of pain on contact at the time of tampon insertion, intercourse, or pelvic examination, and 83% also reported pain on contact that limited or prevented sexual intercourse. These strong associations with a vestibulodynia diagnosis were not observed with respect to women who reported vulvar pain symptoms of burning or knifelike pain, or vulvar pain characteristics of continuous versus intermittent pain, or provoked versus spontaneous pain.Conclusions: Our findings suggest that a small number of symptoms may be suitable for identifying a large proportion of women suffering from vestibulodynia which may be ideal for the development of an effective screening test in the future. However, we also recognize that a large proportion of women experiencing vulvar pain symptoms will not meet the diagnostic criteria for vestibulodynia. Thus, implementing such a screening procedure as part of a routine examination or testing would require a subsequent pelvic examination to confirm a vestibulodynia diagnosis and to rule out other known explanations for vulvar pain.