The role of vaginal apex excision in the management of persistent posthysterectomy dyspareunia
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This paper reviews the management of persistent posthysterectomy dyspareunia, focusing on the role of vaginal apex excision.
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Abstract
ObjectiveThe purpose of this study was to evaluate the effectiveness of vaginal apex excision in the treatment of patients with posthysterectomy dyspareunia.Study designThis was a case series with an independent third-party survey of patients with posthysterectomy dyspareunia managed at the University of Utah Pelvic Pain Clinic. Thirteen patients were first treated with local injections of anesthetics into localized vaginal pain foci. Further evaluation included formal psychometric testing and a diagnostic spinal block. Nine patients underwent surgical excision of the vaginal apex. An independent interviewer who did not know the patients assessed the effects of this procedure on dyspareunia and coital frequency at a mean of 36.4 +/- 3.7 months after the operation.ResultsThe mean coital verbal analog pain score (1-10 scale) decreased from 9.22 +/- 0.27 before excision of the vaginal apex to 3.11 +/- 0.84 after the operation (P <.001), and coital frequency improved from 5.22 +/- 2.02 episodes per month before surgery to 11.11 +/- 1.82 episodes per month after surgery (P =.02). Of the 9 patients, 5 essentially had the dyspareunia cured. Dyspareunia was decreased and coital frequency was markedly increased in all but 1 of the other 4 cases.ConclusionExcision of the vaginal apex is an effective treatment for carefully selected patients with posthysterectomy dyspareunia.
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References (4)
- W54697402 via openalex
- W2029025253 via openalex
- W2046911225 via openalex
- W2520740482 via openalex
Cited by (6)
- Evidence for Surgery for Pelvic Pain 2021
- Vault Endometriosis: Detailed Step-by-Step Laparoscopic Surgical Management Technique 2021
- Dolor Pélvico Crónico 2014
- Chronic Pelvic Pain 2014
- Laparoscopic Posthysterectomy Vaginal Vault Excision for Chronic Pelvic Pain and Deep Dyspareunia 2009
- The role of laparoscopy in the diagnosis and treatment of conditions associated with chronic pelvic pain 2004
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