American Journal of Obstetrics & Gynecology
Volume 198, Issue 1 , Pages 41.e1-41.e5, January 2008

Multilevel local anesthetic nerve blockade for the treatment of vulvar vestibulitis syndrome

  • Andrea J. Rapkin, MD

      Affiliations

    • Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA Los Angeles, CA
    • ,
  • John S. McDonald, MD

      Affiliations

    • Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA Los Angeles, CA
    • Department of Anesthesiology, Harbor–UCLA Medical Center, Los Angeles, CA.
    • ,
  • Melinda Morgan, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA Los Angeles, CA

Received 24 January 2007; received in revised form 13 April 2007; accepted 7 June 2007. published online 15 October 2007.

Objective

Vulvar vestibulitis syndrome is a major cause of dyspareunia. This pilot study was designed to evaluate a novel treatment approach.

Study Design

This is a prospective study of 27 women with vulvar vestibulitis. The protocol included 5 treatment sessions with caudal epidural, pudendal nerve block, and vestibular infiltration of local anesthetic agents.

Results

There were significant improvements in vestibular pain as determined by the vulvalgesiometer, McGill pain questionnaire, self-report, and the Female Sexual Functioning Inventory.

Conclusion

Serial multilevel nerve blocks administered for the treatment of vulvar vestibulitis is a conceptually neurophysiologically based modality that may be effective and merits a placebo-controlled study.

Key words: dyspareunia, local anesthetics, vulvar vestibulitis syndrome

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 Cite this article as: Rapkin AJ, McDonald JS, Morgan M. Multilevel local anesthetic nerve blockade for the treatment of vulvar vestibulitis syndrome. Am J Obstet Gynecol 2008;198:41.e1-41.e5.Reprints not available from the authors.

PII: S0002-9378(07)00737-5

doi:10.1016/j.ajog.2007.06.008

American Journal of Obstetrics & Gynecology
Volume 198, Issue 1 , Pages 41.e1-41.e5, January 2008

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