Off-campus Pacific University users: To download campus access theses and dissertations, please log into our proxy server with your PUNet ID and password.

Non-Pacific University users: Please talk to your librarian about requesting this thesis or dissertation through interlibrary loan.

Theses or dissertations that have a specific embargo period indicated below will not be available to anyone until the date indicated.

Date of Graduation

8-2005

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Jonathon W. Gietzen MS PA-C

Abstract

Context Vulvar vestibulitis is a characterized by persistent itching, burning, and vulvar pain that appears to be more prevalent in young females today. In light of the accelerated prevalence of this condition, there is a serious need for a better understanding of this condition since evidence suggests, although not life-threatening, vulvar vestibulitis appears to have a significant impact on quality of life.

Objective To systematically review the background, etiology, and efficacy of methods advocated for prevention and treatment of vulvar vestibulitis.

Data Sources, Study Selection, and Data Extraction The CINHAL, MEDLINE, and OVID databases were searched for articles published between January 1980 and May 2005 using database-specific keywords. Bibliographies of retrieved articles were searched, along with the Cochrane Library. and relevant websites. Reference textbooks were also searched for further background and supporting information. The retrieved literature was reviewed for pertinent information.

Data Synthesis. Vulvar vestibulitis syndrome was recognized over a century ago, yet the etiology still remains unknown. Definitions of pain provocation, quality, duration, and distribution vary, but patients typically have a history of pain localized to the vulvar vestibule described as burning or stinging; discomfort is elicited by direct pressure to the affected area. Activities such as tampon insertion, wearing tightly fitting clothing, biking, and horseback riding can result in extreme pain. Sexual activity can be problematic, and severe dyspareunia can lead to partial or complete cessation of intercourse. Most women experience at least 2-3 years of vulvar discomfort before being properly diagnosed. Many other treatable conditions have similar presenting symptoms, so a thorough patient history and physical exam is necessary . Because external genitalia often appears normal on gross inspection, vulvar vestibulitis is often overlooked. If gentle pressure is applied with a cotton applicator, and focal areas of tenderness can be elicited; this is diagnositic. Treatment requires a multidisciplinary approach with clinician and counselor involvement; there have been some promising results in small clinical trials, but there has not been one effective proven method to eradicate all symptoms.

Conclusions It is important that health care practitioners learn to recognize this crippling, chronic condition; No one specific treatment has been proven effective in clinical trials. Therefore, each individual needs to be examined and tested to rule out other causative agents. Documentation of a thorough patient history and attention to specific patient variables will help guide the medical provider in selection of the most appropriate treatment options.

Comments

The digital version of this project is currently unavailable to off-campus users; however, it may be requested via interlibrary loan by eligible borrowers from Pacific University Library. Pacific University Library is a free lender. (Library Use: NL)

Share

COinS