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Ginekologia i Położnictwo medical project
ISSN 1896-3315 e-ISSN 1898-0759

Vulvodynia ? diagnosis and treatment


Abstract

Author(s): ANNA MARKOWSKA

Vulvodynia involves a chronic, lasting for at least 3 to 6 months permanent or provoked vulvarpain of various intensity, accompanied by no evident clinical pathology but negatively affec-ting female quality of life. Even if the condition was described for the first time in the 1980-ties, its cause remains to be fully clarified. In studies on women with vulvodynia, augmentedconcentrations of nerve growth factor (NGF) were described, which may explain the overgrownnetwork of distal nerve fibres and their increased density as well as, the demonstrated in79% women with vulvodynia, proliferation of peripheral nerves in tissues of vestibule of thevagina. Treatment of vulvodynia is complex and frequently ineffective. Drugs of the localrelieving action include 5% lidocain, nitroglycerin-containing cream and injections of Cl.botulinum toxin. Among the drugs of systemic action, the most effective proved to be tricyclicantidepressants (amitriptyline, nortriptyline) and some anti-convulsants (gabapentine, carba-mazepine), applicable also in neuralgia of trigeminal nerve.