Successful therapy of vulvodynia with local anesthetics: Results from an observational study

Purpose Vulvodynia, vulvar pain without morphological substrates, has a prevalence of 6-15 %. To investigate the effectiveness of therapy with local anesthetics (TLA, neural therapy) on severe vulvodynia, we conducted a prospective, non-controlled observational study.

Methods 45 patients with severe chronic vulvodynia (primary and secondary vulvodynia, NAS ≥6, median 7.9, duration of ≥6 months, median 65.2 months) were treated with TLA in 3-12 sessions. Effectiveness was analyzed using Wilcoxon signed rank tests and Wilcoxon rank sum tests. We defined therapeutic success as pain reduction to ≤4 on a 0-10 numeric analogue scale (NAS) lasting for ≥ 3 months after end of therapy.

Results TLA successfully reduced vulvodynia in 36 of 45 patients (80 %, responders) with a mean reduction from 7.9 to 2.4 (p < 0.001). Even patients denominated as non-responders experienced a significant reduction in NAS (p = 0.03). In responders, long-term success lasted for 3.8-121 months (median 21.1 months). No adverse events occurred.

Conclusion This pilot study provides first insights into the effectiveness of TLA in vulvodynia. TLA is easy to apply and promises long-term pain reduction in vulvodynia. The success of TLA observed offers new perspectives on its etiology as a complex pain syndrome affecting several nerves of the pelvic floor.

Effekt der TLA bei Vulvodynie, primäre/sekundäre Form, und bei Respondern und Nicht-Respondern.

Publication History

Article published online:
07 October 2020