Review Article, J Genit Syst Disor Vol: 3 Issue: 1
Localized Provoked Vestibulodynia: Do Multiple Etiologic Triggers Manifest as Neurogenic Vulvar Pain?
| Miranda A Farage1*, Kenneth W Miller1 and William J Ledger2 | |
| 1Feminine Care Innovation Center, The Procter & Gamble Company, Cincinnati OH, USA | |
| 2Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, USA | |
| Corresponding author : Miranda Farage The Procter & Gamble Company, Winton Hill Technical Center, 6110 Center Hill Rd Box 136, Cincinnati, OH 45224, USA Tel: 514-634-5594; Fax: 866 622 0465 E-mail: farage.m@pg.com |
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| Received: September 11, 2013 Accepted: December 27, 2013 Published: January 10, 2014 | |
| Citation: Farage MA, Miller KW, Ledger WJ (2014) Localized Provoked Vestibulodynia: Do Multiple Etiologic Triggers Manifest as Neurogenic Vulvar Pain?. J Genit Syst Disor 3:1. doi:10.4172/2325-9728.1000116 |
Abstract
Localized Provoked Vestibulodynia: Do Multiple Etiologic Triggers Manifest as Neurogenic Vulvar Pain?
We propose that localized provoked vestibulodynia (LPV) results from diverse precipitating factors that ultimately establish and maintain neurogenic pain responses. An immune-cell–mediated inflammatory cascade may be the common mechanism through which various triggers establish neurogenic vulvar pain. Distinct etiologies of localized provoked vestibulodynia that manifest through neurogenic pain pathways may include its development subsequent to vulvovaginal infection, its comorbidity with and interstitial cystitis, and the role of sex hormones in triggering vestibulodynia. The medical history, the presence of genetic predisposing factors, the focal pattern and severity of vestibular pain, the pattern of subclinical inflammation along genital tract, and the presence of immune cell mediators and neuronal hyperplasia may provide clues as to the underlying pathophysiology of this perplexing syndrome.
