Vulvar Vestibulitis syndrome (VVS)

摘要： 子项目2：外阴前庭炎综合征（WS）是最常见的慢性外阴-阴道疼痛类型，对大约10%的妇女在其生命中的某个阶段的心理、身体和生殖健康产生负面影响。尽管有几十年的研究，WS的病因和病理生理学仍然未知。目前的治疗主要是经验性的，更多地由个别临床医生的先前经验和舒适度水平而不是关于治疗效果的客观数据来指导。最近的证据表明，WS的病因涉及生物和心理过程的损害，类似于其他慢性疼痛疾病。虽然诊断为WS的女性表现为一系列的粘膜敏感性、盆腔肌肉功能障碍和心理困扰，但WS的实际诊断仍然依赖于相对粗糙的粘膜敏感性测量缺乏严格的评估标准，并且依赖于临床医生和患者的高度主观测量，表明这种诊断目前还没有得到很好的限制。因此，它可能包括一个异质的，潜在的分歧组的妇女与唯一的共同特点的挫折与持续外阴疼痛和性交困难。

Abstract: Subproject 2 WS. Vulvar Vestibulitis Syndrome (WS), the most common type of chronic vulvo-vaginal pain, negatively impacts the psychological, physical, and reproductive health of approximately 10% of women at some point in their life. Despite decades of research, the etiology and pathophysiology of WS remain unknown. Current treatments are largely empiric and guided more by an individual clinician's prior experience and comfort level than objective data on therapeutic efficacy. Recent evidence suggests that the etiology of WS involves impairment of biological and psychological processes, similar to those of other chronic pain disorders. Although women diagnosed with W S present with a spectrum of mucosal sensitivity, pelvic muscle dysfunction, and psychological distress, the actual diagnosis of WS continues to rely on relatively crude measures of mucosal sensitivity (cotton swab palpation and patient report of pain) on clinical exam. A lack of strict criteria for evaluation, and dependence on highly subjective measures by both clinician and patient, suggests that this diagnosis is currently poorly circumscribed. As such, it is likely to encompass a heterogeneous, potentially divergent group of women with the sole common feature of frustration with persistent vulvar pain and dyspareunia.