Early experience with topical meloxicam and lidocaine combination for the treatment of vulvodynia.

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Topical application of a meloxicam and lidocaine combination gel resulted in subjective symptom improvement and pain reduction for six of eight participants with vulvodynia, despite common side effects like burning.

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This study evaluated the efficacy of a topical combination gel containing 0.3% meloxicam and 5% lidocaine for treating vulvodynia in eight participants at a pelvic pain clinic. Patients applied the gel twice daily, with symptom improvement assessed via standardized indices and pain scoring scales after one week. Six participants reported subjective improvements ranging from mild to moderate, along with reductions in pain scores, although some experienced side effects like burning and stinging. The authors concluded that these early observations are promising for this potential treatment modality. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

IntroductionWe report our early clinical observations on the use of topical meloxicam and lidocaine gel for patients with vulvodynia.MethodsThis is an early experience in participants with a history of vulvodynia evaluated and treated at the Queen's University Pelvic and Bladder Pain Clinic. Combination meloxicam 0.3% and lidocaine 5% were provided to the participants and they were instructed to apply 5 cc to the vulvar area twice daily. Standardized assessment was conducted for each participant before the start of the topical therapy and again at one week, and included Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and pain scoring (Likert) for vulvar pain, in addition to a subjective global assessment after a week of treatment.ResultsOf the eight participants, six had a subjective improvement in their symptoms with the use of the combination gel. They reported between one- and four-point reductions on the Likert pain scale and mild to moderate improvement of symptoms. Common side effects reported were burning and stinging.ConclusionsThe results from this early experience are promising for a potentially effective topical treatment for vulvodynia.
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Introduction

We report our early clinical observations on the use of topical meloxicam and lidocaine gel for patients with vulvodynia.

Methods

This is an early experience in participants with a history of vulvodynia evaluated and treated at the Queen’s University Pelvic and Bladder Pain Clinic. Combination meloxicam 0.3% and lidocaine 5% were provided to the participants and they were instructed to apply 5 cc to the vulvar area twice daily. Standardized assessment was conducted for each participant before the start of the topical therapy and again at one week, and included Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and pain scoring (Likert) for vulvar pain, in addition to a subjective global assessment after a week of treatment.

Results

Of the eight participants, six had a subjective improvement in their symptoms with the use of the combination gel. They reported between one- and four-point reductions on the Likert pain scale and mild to moderate improvement of symptoms. Common side effects reported were burning and stinging.

Conclusions

The results from this early experience are promising for a potentially effective topical treatment for vulvodynia. Downloads Downloads Published How to Cite Issue Section License You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA: - Post the Article on any Web site - Translate or authorize a translation of the Article - Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so - Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so. The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request. You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article. The CUA also requires you to warrant the following: - That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party; - That all individuals who have made a substantive contribution to the article are acknowledged; - That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and - That the Article does not libel or violate the privacy rights of any third party.

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