Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
Journal website https://www.jcgo.org

Review

Volume 10, Number 2, June 2021, pages 35-39

Vulvar Endometriosis Mimicking as Primary Vulvodynia in a Young Nulliparous Woman: Algorithm of Care Following a Rapid Literature Review

Table

Table 1. Differences Among Vulvar Endometriosis, Superficial Dyspareunia and 1ry Vulvodynia
 
Vulvodynia (1ry)Superficial dyspareuniaVulvar endometriosis
+: some benefit; ++: more benefit; +++: great benefit. GnRHa: gonadotrophin-releasing hormone agonists; POP: progestagen-only pill.
Duration of symptomsUsually chronicVaried, but could be of short durationChronic with cyclical variation
SiteIntroitus lower vaginaVestibuleSpecific areas over the vulva, lower vagina
Age of womanVariableVariableUsually younger if no preceding vaginal trauma
Trigger factorPresent: candidiasis is a common agentPresent: tampon use, negative sexual/relationship historyNone, menstrual cycle predisposition
Coexisting/aggravating factors
  SwellingsNoneMaybe presentSmall or tiny deposits/bluish nodules or chocolate fluid-filled cysts
  DermatosesNoneMaybe presentNone
  UlcersNoneMaybe presentHas been described
  InfectionsNoneMaybe presentNone
  Pelvic floor musclesVery hypertonicSome hypertonicHypertonia during menstruation
Treatment
  Medical treatmentBenefit +/++Benefit ++Benefit
  Physical therapiesBenefit +/++Benefit +/++No benefit
  Psychological therapiesBenefit +/++Benefit ++Of no benefit
  Vulval care regimeBenefit +/++Benefit +/++Of no benefit
  Hormone useMay be beneficialMay be beneficialEstrogen exacerbates: POP/GnRHa may help
  Surgical interventionBenefit + vestibulectomyBenefit depending on etiologyBenefit +++
Excision of small area/cyst as cancer risk in recurrent cases