Krisztina Bajzak, Alex Rains, Lisa Bishop, Michelle Swab, Michelle E Miller, Gabrielle S Logan, Victoria Jackman, Liam Jackman, Diana L Gustafson
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引用次数: 0
Abstract
Introduction: Localized provoked vulvodynia (LPV) is a chronic pain condition without an identifiable cause that is localized to a portion of the vulva and provoked by pressure or touch. LPV is a commonly occurring but poorly understood condition lacking consensus on management.
Method: This scoping review used Arksey and O'Malley's approach to identify and evaluate literature published between 2010 and 2023 that addressed the question: What is the current evidence on the efficacy or effectiveness of pharmacological treatments in the management of LPV?
Results: This review evaluated 18 papers reporting on the efficacy or effectiveness of oral, topical, and injectable medications. Seven of the studies were randomized controlled trials. Oral gabapentin and oral desipramine showed some improvement in sexual function compared to placebo. Small sample sizes and methodological issues limited confidence in interpreting findings. Pain was reduced in descriptive studies of tricyclic antidepressants, milnacipran, injectable anesthetics, and botulinum toxin. Where pain did not improve with treatment, some oral medications improved participants' mood and sexual function. Some topical agents may be effective in reducing peripherally mediated neuropathic pain. Botulinum toxin was the most well-studied injectable but yielded mixed outcomes related to pain, quality of life, and sexual function.
Conclusion: There is a lack of convincing evidence to draw conclusions about the efficacy or effectiveness of pharmacological therapies for LPV. The breadth of therapies for treating LPV warrants the development of evidence-based, consensus guidelines for measuring treatment outcomes and improving comparisons across studies. Recommendations for research include addressing methodological shortcomings and diversifying the participant pool to increase the generalizability of findings.
期刊介绍:
As the official journal of the World Association for Sexual Health, the International Journal of Sexual Health promotes sexual health as a state of physical, emotional, mental, and social well-being through a positive approach to sexuality and sexual rights. The journal publishes peer-reviewed scientific papers, editorials, and reviews, using quantitative and qualitative methods, descriptive and critical analysis, instrument development, surveys, and case studies to examine the essential elements of this broad concept. Leading experts from around the world present original work that covers a variety of disciplines, including sexology, biology, medicine, psychology, sociology, anthropology, history, and religion.