Provoked Vestibulodynie (PVD, vulvar vestibulitis, Vestibulitis-vulvae syndrome, localized vulvar dysesthesia) is the most common form of superficial (introitalen) dyspareunia. Pain is caused by introitalen pressure. Treatment includes psychotherapy, which are used in chronic pain syndromes. In addition, is treated with topical lidocaine or cromoglycate; when the products are used alone, however, their effectiveness has not been established.

Provoked Vestibulodynie occurs when the nervous system – by peripheral receptors in the cerebral cortex – sensitized and is rebuilt. By sensitizing the uncomfortable feeling for a stimulus that would otherwise be perceived only as easy or insignificant (z. B. touch), perceived as significant pain (allodynia) is. This disorder is probably a chronic pain syndrome (chronic pain). The peripheral sensitization results in a neurogenic inflammatory response. A small group of women beside a PVD vulvovaginal candidiasis, which could contribute to the development of a PVD.

Provoked Vestibulodynie (PVD, vulvar vestibulitis, Vestibulitis-vulvae syndrome, localized vulvar dysesthesia) is the most common form of superficial (introitalen) dyspareunia. Pain is caused by introitalen pressure. Treatment includes psychotherapy, which are used in chronic pain syndromes. In addition, is treated with topical lidocaine or cromoglycate; when the products are used alone, however, their effectiveness has not been established. Provoked Vestibulodynie occurs when the nervous system – by peripheral receptors in the cerebral cortex – sensitized and is rebuilt. By sensitizing the uncomfortable feeling for a stimulus that would otherwise be perceived only as easy or insignificant (z. B. touch), perceived as significant pain (allodynia) is. This disorder is probably a chronic pain syndrome (chronic pain). The peripheral sensitization results in a neurogenic inflammatory response. A small group of women beside a PVD vulvovaginal candidiasis, which could contribute to the development of a PVD. Symptoms and complaints Introitaler pressure, penile movements or ejaculation of a man caused at Vestibulodynie most immediate pain. The pain can usually after when the movements of the penis (or dildo) are finished and put back on when they start again. A Vestibulodynie can also cause postcoital burning and dysuria. Diagnosis Clinical Investigation The diagnosis is made clinically and confirmed by a swab test on allodynia. Vaginismus causes similar pain in pressure on the vaginal orifice as well as the penetration and movement of the penis. However, vaginismus usually caused unlike Vestibulodynie no allodynia or post-coital symptoms. Some women with allodynia have in their medical history clear indications of vaginismus (d. H. Phobia like avoiding vaginal penetration), suggesting that Vestibulodynie can develop as a result of vaginismus and overlap allodynia and vaginismus. Treatment psychotherapies used in chronic pain syndromes treatment of sexual disorder that occurs as a result of the pain pelvic floor physiotherapy Additionally, drugs for chronic pain might topical lidocaine or cromoglycate before penetration The optimal treatment of provoked Vestibulodynie is unclear; the approaches are currently diverse, and probably still exist undefined subtypes that require a more sophisticated treatment. Since chronic pain occurs in this disease, the treatment is broad, including stress management and therapies to identify the thoughts and feelings that accompany the pain. Beneficial therapy in small groups seems to be a mindfulness-based cognitive therapy or cognitive behavioral therapy (treatment) combined with education about chronic pain, PVD, sexuality and stress. Occasionally, an adjuvant drug therapy (eg. B. antidepressant or antiepileptic) is used. Once a penetration test can be done locally drugs (lidocaine solved in a free of additives moisturizer z. B. 2% sodium cromoglycate or 2- or 5%) can be applied in order to interrupt the cycle of chronic pain. Cromoglycate stabilizes the membrane of white blood cells, including mast cells, making the PVD is interrupted underlying neurogenic inflammation. Cromoglycate or lidocaine must be administered using a 1 ml syringe without a needle precisely to the area of ??allodynia. Supervision by a physician and (at least initially) the use of a mirror are helpful. Women with an increased tone of the pelvic floor muscles can benefit from targeted pelvic floor physiotherapy, which is possibly supported by biofeedback. As a surgical procedure occasionally excision of the hymen, the proximal edge of the lower vagina and the innermost part of the labia minora to use, mostly in women without depression, anxiety or without the involvement of introitalen Rändes near the urethra, when they had sexual intercourse without pain before and are willing to participate also in psychotherapy. However, the pain associated with the regeneration of the nerve may recur. Some women with PVD and vaginal candidiasis benefit from a long-term prophylaxis of Candida (eg., Weekly vaginal Borsäurekapseln). Summary Provoked Vestibulodynie (a chronic pain syndrome) is characterized by local pain due to a non-violating introitalen pressure. Introitaler pressure (eg. As by the movement of the penis or Toys or by ejaculation) directly caused pain, which usually subside when the pressure ceases. By provoking pain with a cotton swab, the diagnosis is confirmed. There are psychotherapies used, sometimes as a supplement to medicaments and / or pelvic floor physiotherapy.

Health Life Media Team

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