Vulvar pain

Introduction Vulvar pain is chronic genital discomfort characterized by burning, stinging, tenderness or irritation. Although the current symptoms of this group of symptoms are collectively referred to as vulvar pain regardless of the cause, it is generally believed that vulvar pain refers only to those whose causes are unknown. Vulvar pain without obvious infection or organic disease is called vulvar pain syndrome (VPS), including vulvar vestibulitis (VV), annular vulvitis, paresthesia vulvar pain, the cause may be multifactorial, related vulvar vestibule There have been many studies of inflammation, and there have been few reports of annular vulvitis and paresthesia.

Cause

Causes of vulvar pain:

Vulvar pain is a group of heterogeneous diseases that may be more multifactorial in the study of vulvar vestibulitis. There are fewer reports of annular vulvitis and paresthesia vulvar.

1. Candida infection: The history of vulvovaginal candidiasis is the only constant feature of patients with vestibular inflammation, but inappropriate topical antifungal drugs can also cause these symptoms. In addition, the rate of Candida colonization in patients with vestibulitis is not higher than that in the control group. The etiology of annular vulvitis is unknown, but Candida albicans may be a potential cause, and anti-candida treatment is usually effective.

2. Iatrogenic factors: patients with vulvar pain often have a history of using topical drugs many times. Because the protective barrier function of the stratum corneum of the vulva skin is not as good as that of other parts of the skin, vulvar stimulation caused by topical drugs is more common. Stimulation may not be the cause of the initial symptoms, but it may prolong the symptoms associated with vulvar pain. The incidence of priming sensitization in this lesion does not increase and there is no histological evidence to confirm or rule out the occurrence of allergic contact dermatitis.

3. Psychological factors: Patients with vulvar pain have obvious psychological and sexual psychological morbidity, but whether it can cause symptoms is still controversial. Insufficient arousal during sexual intercourse can cause less lubrication and cause vulvovaginal irritation, while periodic vulvar irritation can cause vulvar pain. However, several studies did not show that the incidence of unpleasant sexual experience or sexual promiscuity was higher in the patients than in the control group, and there was no obvious sexual psychological disorder in the sexual partners.

4. Genetic quality: Vulvar pain occurs in white blacks and Asians. This is the true genetic predisposition or the influence of socio-demographic factors.

an examination

Related inspection

Vulvar gynecological routine examination of vaginal biopsy

Diagnosis and examination of vulvar pain:

At the time of initial diagnosis, patiently listen to the patient's complaints, carefully examine the vulva and vaginal opening, and perform microscopic examination and PCR detection on vaginal secretions. First, it is necessary to eliminate various vulvar painful diseases with clear etiology. Fully understand all the symptoms of patients with chronic genital pain, vestibular inflammation mainly manifested as sexual pain, vestibular erythema and irritation pain, ring vulvitis is more common in young women when there is a ring-shaped erythema in the vulva and a little Desquamation sensation, abnormal vulvar pain has no obvious signs but can be diagnosed according to persistent dull or non-irritating pain in women who are in menopause.

Laboratory inspection:

Direct microscopic examination of vaginal secretions: Polymerase chain reaction (PCR) detection of fungal human papillomavirus can be detected, and some patients can detect human papillomavirus.

Differential diagnosis

It should be differentiated from cancer pain. The occurrence of cancer pain is the result of multiple factors. In the process of its pathogenesis, there are pathological changes and psychological factors. Therefore, when applying the above rules, we must pay attention to the combination of syndrome differentiation. , comprehensive analysis, in order to play a better therapeutic effect. Cancer pain affects mood and confidence affects all symptoms. However, some patients express negative emotions through physical symptoms and enclose themselves in the great pain of recurrence. Functional abdominal pain (intestinal irritation syndrome) may be the patient's life. The way to express negative emotions.

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