Pelvic Floor and Other Pelvic Disorders: Difference between revisions
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== '''Vulvodynia'''<br> == | == '''Vulvodynia'''<br> == | ||
=== Definition<br> === | === Definition<br> === | ||
Vulvar discomfort occuring in the absence of relevant visible findings or a specfici, clinically-identifiable, neurological disorder. <br> | Vulvar discomfort occuring in the absence of relevant visible findings or a specfici, clinically-identifiable, neurological disorder. <br> | ||
=== Symptoms<br> === | === Symptoms<br> === | ||
*Burning<br> | *Burning<br> | ||
*Stabbing<br> | *Stabbing<br> | ||
*Stinging<br> | *Stinging<br> | ||
*Itching<br> | *Itching<br> | ||
*Allodynia (light touch perceived as pain)<br> | *Allodynia (light touch perceived as pain)<br> | ||
*Hyperalgesia (mildly noxious stimulus perceived as severely noxious)<br> | *Hyperalgesia (mildly noxious stimulus perceived as severely noxious)<br> | ||
*Functional limitation (e.g. pain during intercourse, using tampons, sitting)<br> | *Functional limitation (e.g. pain during intercourse, using tampons, sitting)<br> | ||
=== Diagnosis<br> === | === Diagnosis<br> === | ||
Symptoms should be present for 3-6 months before this diagnosis is considered. <br> | Symptoms should be present for 3-6 months before this diagnosis is considered. <br> | ||
Other conditions that should be ruled out include;<br> | Other conditions that should be ruled out include;<br> | ||
*Vulvovaginal candidiasis<br> | *Vulvovaginal candidiasis<br> | ||
*Bacterial vaginosis<br> | *Bacterial vaginosis<br> | ||
*Trichomoniasis<br> | *Trichomoniasis<br> | ||
*Genital herpes<br> | *Genital herpes<br> | ||
*Neuropathic viruses (e.g. Herpes zoster)<br> | *Neuropathic viruses (e.g. Herpes zoster)<br> | ||
*HPV<br> | *HPV<br> | ||
*Lichens simples chronicus<br> | *Lichens simples chronicus<br> | ||
*Lichens simples sclerosus<br> | *Lichens simples sclerosus<br> | ||
*Lichens planus<br> | *Lichens planus<br> | ||
*Contact dermatitis<br> | *Contact dermatitis<br> | ||
*Atrophic vaginitis<br> | *Atrophic vaginitis<br> | ||
*Squamous cell carcinoma <br> | *Squamous cell carcinoma <br> | ||
*Pudendal nerve injury <br> | *Pudendal nerve injury <br> | ||
*Referred pain from sacral nerve roots after disc injury <br> | *Referred pain from sacral nerve roots after disc injury <br> | ||
*Neurologic disease (e.g. MS)<br> | *Neurologic disease (e.g. MS)<br> | ||
=== Classifications<br> === | === Classifications<br> === | ||
Generalized vulvodynia;<br> | Generalized vulvodynia;<br> | ||
*Almost constant, typically burning pain<br> | *Almost constant, typically burning pain<br> | ||
*Affects the entire vulva<br> | *Affects the entire vulva<br> | ||
*Provoked (sexual, non-sexual or both)<br> | *Provoked (sexual, non-sexual or both)<br> | ||
*Unprovoked<br> | *Unprovoked<br> | ||
*Mixed (provoked and unprovoked) <br> | *Mixed (provoked and unprovoked) <br> | ||
Localized vulvodynia / vestibulodynia; <br> | Localized vulvodynia / vestibulodynia; <br> | ||
*Localized to vulvar vestibule <br> | *Localized to vulvar vestibule <br> | ||
*Burning / cutting pain at entrance of vagina <br> | *Burning / cutting pain at entrance of vagina <br> | ||
*Provoked (sexual, non-sexual or both)<br> | *Provoked (sexual, non-sexual or both)<br> | ||
*Unprovoked <br> | *Unprovoked <br> | ||
*Mixed (provoked and unprovoked) <br> | *Mixed (provoked and unprovoked) <br> | ||
=== Co-Morbidities<br> === | === Co-Morbidities<br> === | ||
*Interstitial cystitis | *Interstitial cystitis | ||
*Fibromyalgia | *Fibromyalgia | ||
*Irritable Bowel Syndrome | *Irritable Bowel Syndrome | ||
*Depression | *Depression | ||
*Dyspareunia | *Dyspareunia | ||
*TMJ or facial pain | *TMJ or facial pain | ||
*Overactive pelvic floor | *Overactive pelvic floor | ||
== Dyspareunia / Vaginismus == | == Dyspareunia / Vaginismus == | ||
=== Definition === | === Definition === | ||
Dyspareunia: Painful vaginal penetration in the absence of disease | Dyspareunia: Painful vaginal penetration in the absence of disease | ||
Vaginismus: Inability to penetrate due to spasm of the muscles | Vaginismus: Inability to penetrate due to spasm of the muscles | ||
=== Causes === | === Causes === | ||
*Painful scar / episotomy | *Painful scar / episotomy | ||
*Vulvodynia - Interstitital cystitis | *Vulvodynia - Interstitital cystitis | ||
*Protective response to infection, inflammation, injury or decreased estrogen or fear | *Protective response to infection, inflammation, injury or decreased estrogen or fear | ||
== Lichens Simplex == | |||
*Chronic irritation of the vulva | |||
*Leads to itching, scratching and thickening of the skin | |||
*Vulva can be weepy, causing moisture | |||
== Lichens Sclerosis == | |||
*Auto-immune disorder | |||
*Itching or burning | |||
*Skin with white patches | |||
*Scars and adhesions of the vulva | |||
*Easily bruised and torn | |||
== Lichens Planus == | |||
*Chronic mucocutaneous disease | |||
*Itching or burning | |||
*Scar adhesions | |||
*On the vulva and in the vagina | |||
*Affects other mucosal membranes e.g. oral, genital, esophageal - oral rash typically occurs first | |||
*Significant pain | |||
== Desquamative Inflammatory Vaginitis == | |||
=== Definition === | |||
*Profuse discharge with irritation of the vulva and vagina | |||
*Inflammation causes the vaginal wall to peel or shed (desquamation) | |||
*No cancerous, contagious or bacterial origin known | |||
=== Signs and Symptoms === | |||
*Pus-like yellow/green discharge | |||
*May be vulvar burning and itching | |||
*Usually no odour | |||
*PAP smear may be abnormal | |||
*No improvement with anti-biotics or anti-fungals | |||
== Atrophic Vaginitis == | |||
*Decreased estrogen causes thinning of the vaginal epithelium leading to inflammation | |||
*Can cause vaginal soreness, itching and dyspareunia | |||
*Sores and cracks can occur spontaneously | |||
*Can have an odours discharge | |||
== Interstitial Cystitis / Painful Bladder Syndrome == | |||
Go to[[Interstitial_Cystitis|this page]] for more information | |||
Revision as of 23:13, 20 April 2014
Vulvodynia
[edit | edit source]
Definition
[edit | edit source]
Vulvar discomfort occuring in the absence of relevant visible findings or a specfici, clinically-identifiable, neurological disorder.
Symptoms
[edit | edit source]
- Burning
- Stabbing
- Stinging
- Itching
- Allodynia (light touch perceived as pain)
- Hyperalgesia (mildly noxious stimulus perceived as severely noxious)
- Functional limitation (e.g. pain during intercourse, using tampons, sitting)
Diagnosis
[edit | edit source]
Symptoms should be present for 3-6 months before this diagnosis is considered.
Other conditions that should be ruled out include;
- Vulvovaginal candidiasis
- Bacterial vaginosis
- Trichomoniasis
- Genital herpes
- Neuropathic viruses (e.g. Herpes zoster)
- HPV
- Lichens simples chronicus
- Lichens simples sclerosus
- Lichens planus
- Contact dermatitis
- Atrophic vaginitis
- Squamous cell carcinoma
- Pudendal nerve injury
- Referred pain from sacral nerve roots after disc injury
- Neurologic disease (e.g. MS)
Classifications
[edit | edit source]
Generalized vulvodynia;
- Almost constant, typically burning pain
- Affects the entire vulva
- Provoked (sexual, non-sexual or both)
- Unprovoked
- Mixed (provoked and unprovoked)
Localized vulvodynia / vestibulodynia;
- Localized to vulvar vestibule
- Burning / cutting pain at entrance of vagina
- Provoked (sexual, non-sexual or both)
- Unprovoked
- Mixed (provoked and unprovoked)
Co-Morbidities
[edit | edit source]
- Interstitial cystitis
- Fibromyalgia
- Irritable Bowel Syndrome
- Depression
- Dyspareunia
- TMJ or facial pain
- Overactive pelvic floor
Dyspareunia / Vaginismus[edit | edit source]
Definition[edit | edit source]
Dyspareunia: Painful vaginal penetration in the absence of disease
Vaginismus: Inability to penetrate due to spasm of the muscles
Causes[edit | edit source]
- Painful scar / episotomy
- Vulvodynia - Interstitital cystitis
- Protective response to infection, inflammation, injury or decreased estrogen or fear
Lichens Simplex[edit | edit source]
- Chronic irritation of the vulva
- Leads to itching, scratching and thickening of the skin
- Vulva can be weepy, causing moisture
Lichens Sclerosis[edit | edit source]
- Auto-immune disorder
- Itching or burning
- Skin with white patches
- Scars and adhesions of the vulva
- Easily bruised and torn
Lichens Planus[edit | edit source]
- Chronic mucocutaneous disease
- Itching or burning
- Scar adhesions
- On the vulva and in the vagina
- Affects other mucosal membranes e.g. oral, genital, esophageal - oral rash typically occurs first
- Significant pain
Desquamative Inflammatory Vaginitis[edit | edit source]
Definition[edit | edit source]
- Profuse discharge with irritation of the vulva and vagina
- Inflammation causes the vaginal wall to peel or shed (desquamation)
- No cancerous, contagious or bacterial origin known
Signs and Symptoms[edit | edit source]
- Pus-like yellow/green discharge
- May be vulvar burning and itching
- Usually no odour
- PAP smear may be abnormal
- No improvement with anti-biotics or anti-fungals
Atrophic Vaginitis[edit | edit source]
- Decreased estrogen causes thinning of the vaginal epithelium leading to inflammation
- Can cause vaginal soreness, itching and dyspareunia
- Sores and cracks can occur spontaneously
- Can have an odours discharge
Interstitial Cystitis / Painful Bladder Syndrome[edit | edit source]
Go tothis page for more information
