Vulvar Vestibulitis syndrome (VVS)

摘要： 子项目2 WS。外阴前庭炎综合征(WS)是一种最常见的慢性外阴-阴道疼痛类型，在她们生命中的某个阶段对大约10%的女性的心理、身体和生殖健康产生负面影响。尽管几十年的研究，WS的病因和病理生理学仍不清楚。目前的治疗在很大程度上是经验性的，更多地是由个别临床医生的先前经验和舒适度指导的，而不是关于治疗效果的客观数据。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障碍。尽管确诊为W S的女性表现出一系列的粘膜敏感性、盆腔肌功能障碍和心理困扰，但实际的WS诊断仍然依赖于临床检查中相对粗略的粘膜敏感性测量(棉签触诊和患者报告疼痛)。缺乏严格的评估标准，以及临床医生和患者对高度主观测量的依赖，表明目前这种诊断的界限很差。因此，它可能包括一个不同的，潜在的不同的女性群体，唯一的共同特征是对持续的外阴疼痛和性交困难感到沮丧。

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.