Parturition after Vestibulectomy
ABSTRACT Introduction. Provoked vestibulodynia is the most common cause of sexual pain in premenopausal women. Vulvar vestibulectomy has been shown to be an effective treatment.Aim. To determine the optimum route of parturition in women who become pregnant after vulvar vestibulectomy.Methods. All women who underwent a complete vulvar vestibulectomy by one of four surgeons were contacted between 12 and 72 months after surgery. For all women who had a term pregnancy and subsequent delivery, the research assistant abstracted data from the charts. Descriptive statistics were applied.Main Outcome Measures. The number of women who underwent a delivery after a vestibulectomy, mode of delivery, and rate of perineal lacerations.Results. Of 109 women, 44 (40%) had undergone at least one term pregnancy and delivery; 23 (52%) were vaginal, and 21 (48%) were cesarean deliveries. Of the vaginal deliveries, 11 (48%) were over an intact perineum. Three (13%) women had a midline episiotomy, none of which extended into third or fourth degree lacerations and one woman (4.4%) sustained a spontaneous fourth degree perineal laceration.Conclusions. Vaginal delivery after vulvar vestibulectomy appears to be a safe option, with no increased perineal morbidity above the general population. Furthermore, it is not an indication for a cesarean delivery. Burrows LJ, Sloane M, Davis G, Heller DS, Brooks J, and Goldstein AT. Parturition after vestibulectomy. J Sex Med 2011;8:303–305.
- Journal of Sexual Medicine 10/2011; 8(10):2663-5. DOI:10.1111/j.1743-6109.2011.02475.x
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ABSTRACT: Vaginismus and dyspareunia most commonly affect women in their childbearing years, yet sexual function, and not childbirth, has been the focus of most research. The aim of this study is to discuss pregnancy and birth outcomes in women with sexual pain disorders (SPDs) and address practical concerns of patients and practitioners regarding management during pregnancy, pelvic examination, labor, and delivery. Review of the relevant literature and recommendations based on clinical expertise of the authors. A review of SPD, conception, and birth outcomes is provided as well as clinical recommendations for prenatal, labor, and delivery management of women with SPD. Practitioners involved in obstetrical care should be knowledgeable about SPD and provide appropriate modifications and interventions.Journal of Sexual Medicine 07/2012; 9(7):1726-35; quiz 1736. DOI:10.1111/j.1743-6109.2012.02811.x
Article: 2013 Vulvodynia Guideline Update[Show abstract] [Hide abstract]
ABSTRACT: Vulvodynia is a complex disorder that can be difficult to treat. Most patients describe it as burning, stinging, irritation, or rawness. Vulvodynia is a costly disease both economically and on its negative impact on patient quality of life. Although many treatment options are available, no one treatment is effective for all patients, thus the need to individualize management. Measures such as gentle vulvar care, medication, biofeedback training, physical therapy, sexual counseling and surgery, as well as complementary and alternative therapies are available to treat the condition with varying success.Journal of Lower Genital Tract Disease 03/2014; 18(2). DOI:10.1097/LGT.0000000000000021