{"paper_id":"814ae02b-5738-4b66-9671-8d7b6517273b","body_text":"Abstract\nBackground\nVulvodynia is a chronic pain condition without an identifiable cause. As such, it is a diagnosis of exclusion, and all other causes of vulvar pain should be excluded. Although a standard treatment for vulvodynia has not been established yet, multidisciplinary care programs appear to be effective.\nPuropose\nThe aim of this retrospective monocentric study was to analyze the prevalence of vulvodynia among women referred to our institution for a suspected diagnosis and to evaluate the efficacy of a multidimensional treatment plan. The primary outcome was the prevalence of vulvodynia following differential diagnosis. Secondary outcomes included: prevalence of the differential diagnoses, symptom resolution rate following treatment, and the relation between persistence of symptoms and (a) patients’ age; (b) coexisting chronic overlapping pain conditions (COPCs).\nResults\nAfter having ruled out all other causes of vulvar pain, only 40.1% of women were considered as affected by vulvodynia. The most frequent differential diagnoses included lower genital tract infections (25.3%), vulvar lichen sclerosus (17.6%) and vulvovaginal atrophy (8.2%). Following a multidisciplinary care program, resolution of symptoms was observed in 13.6% cases, improvement in 64.3% and persistence in 21.9%. We did not find a statistically significant association between persistence of symptoms and age > 38 years (OR 2.10; p = 0.30). Women with one or more COPCs other than vulvodynia had a 75% increased risk of not obtaining a resolution of symptoms (OR 1.75; p = 0.44).\nConclusion\nA thorough differential diagnosis and a multidisciplinary care program may represent a first way out of the muddle in the management of these patients.\nSimilar content being viewed by others\nReferences\nCorsini-Munt S, Rancourt KM, Dubé JP, Rossi MA, Rosen NO (2017) Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. J Pain Res 10. https://doi.org/10.2147/JPR.S126259\nBornstein J, Goldstein AT, Stockdale CK, Bergeron S, Pukall C, Zolnoun D et al (2015) ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. Obstet Gynecol 2016:127. https://doi.org/10.1097/AOG.0000000000001359\nBergeron S, Reed BD, Wesselmann U, Bohm-Starke N (2020) Vulvodynia. 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Eur Spine J. https://doi.org/10.1007/s00586-023-07687-4\nAcknowledgements\nThe authors are grateful to Mirella Di Martino for her incomparable contribution to the study by treating with physical therapy the patients included in the study.\nFunding\nThis study was not founded.\nAuthor information\nAuthors and Affiliations\nContributions\nVeronica Boero and Giulia Emily Cetera: project development, conceptualization, methodology, investigation, writing—original draft, writing—review and editing. Carlotta Caia: formal analysis, data curation, writing—review and editing. Camilla Erminia Maria Merli, Elisa Pesce and Giada Gramegna: data curation and editing. Giussy Barbara: review and editing. Ermelinda Monti: conceptualization, review. Paolo Vercellini: methodology, review and editing.\nCorresponding author\nEthics declarations\nCompeting interests\nThe authors declare no financial or non-financial conflicts of interest.\nEthics approval\nLocal Institutional Review Board approval was obtained (#154_2023, Comitato etico Milano 2).\nConsent to participate\nNot applicable.\nConsent to participation\nNot applicable.\nAvailability of data and materials\nOn request.\nCode availability\nNot applicable.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nBoero, V., Cetera, G.E., Caia, C. et al. Beyond vulvodynia: from a correct diagnosis to a multidisciplinary care program. A referral center experience. Arch Gynecol Obstet 310, 1189–1195 (2024). https://doi.org/10.1007/s00404-024-07496-0\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-024-07496-0","source_license":"public-domain-us","license_restricted":false}