Combination of measures can relieve symptoms of vestibular inflammation

This conclusion was reached by the Swedish Board of Medical and Social Evaluation, SBU, in a في new report To diagnose and treat the pain condition that mainly affects young women, the biggest name of which is vestibular inflammation.

Various physiotherapy measures judged together to give this effect are manual therapy, patient education, pelvic floor muscle training, and home exercises. The effect can last up to six months after the end of treatment, according to the authority.

Read also: Great lack of knowledge about the vestibule

The results are based on one randomized study from Canada on 212 patients. The study was the only clinical study in the review authority that had a reasonably reliable result.

The results of the study are promising and strengthen the approach we already use for this group of patients, which is to reduce pain, reduce tension in the pelvic floor muscles and support the women psychologically, says Nina Bohm Stark, associate professor and chief medical officer at the hospital. The gynecological clinic at Danderyd Hospital, one of the report’s authors.

Other types of treatment, such as medication, psychological interventions, and surgery, cannot be evaluated due to the uncertain data. The expert team also did not find any good studies on diagnostic methods for provoking vulvitis.

One of the lessons is that there are many knowledge gaps in this area, which hardly surprise those of us who work with this group of patients. At the same time, the absence of scientific evidence is not synonymous with a lack of effective treatments. “I think we can help many women very well,” says Nina Bohm Stark.

She and her colleagues are now calling for more quality studies. You mainly want to see research on combined or multidisciplinary treatments because these ways of working are the ones that are considered best in clinical practice.

It would also be desirable for more standardized outcome measures to be agreed so that results could be compared more easily between studies, says Nina Bohm Stark.

Pain in provoked vulvitis originates from the mucous membrane of the vaginal opening. Touching the tissue causes severe burning pain. The cause of the pain is unknown, which, according to Nina Bohm Stark, also contributes to the difficulties in finding an appropriate treatment method.

Why should the diagnosis now be called excitatory vulvitis and not vestibular inflammation?
The older name indicates that the condition is caused by inflammation, which is incorrect. Therefore, since 2015, international research circles began to use excitatory vulvitis, which better describes what it is about. Within the Swedish Society of Obstetrics and Gynecology, we also want to create a new concept, says Nina Bohm Stark.

The SBU report is the result of the government’s commissioning of painful gynecological diseases. As a result of the same customization, the authority also published one recently Lipoedema report.