Re: Surgical outcomes Vestibulodynia after 2 1/2 yrs

[Guest guest]

Great article. Wish there were more studies that look into the long

term as far as vestibulectomy. It would be good to see more

information on how women are doing years after their surgeries. (mine

was in 2001 and been doing very well since about 8 months post op).

Bunny

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> New report just out.

> Dee

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> Obstetrics & Gynecology 2008;111:159-166

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> Surgical and Behavioral Treatments for Vestibulodynia

> Two-and-One-Half–Year Follow-up and Predictors of Outcome

> Sophie Bergeron, PhD1,2, Samir Khalifé, MD3, I. Glazer, PhD4

and Yitzchak M. Binik, PhD1,5

> From the Department of Sexology, 1Université du Québec à Montréal,

and the Department of Psychology, 2McGill University Health Centre

(Royal Hospital), Montréal, Québec, Canada; 3Department of

Obstetrics and Gynecology, Jewish General Hospital, Montréal, Québec,

Canada; 4Departments of Obstetrics and Gynecology and Psychiatry,

Weill College of Medicine, Cornell University, New York, New York,

and New York Presbyterian Hospital, New York, New York; and

5Department of Psychology, McGill University, Montréal, Québec,

Canada.

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> OBJECTIVE:

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> To estimate whether treatment gains for provoked vestibulodynia

participants randomly assigned to vestibulectomy, biofeedback, and

cognitive–behavioral therapy in a previous study would be maintained

from the last assessment—a 6-month follow-up—to the present 2.5-year

follow-up. Although all three treatments yielded significant

improvements at 6-month follow-up, vestibulectomy resulted in

approximately twice the pain reduction as compared with the two other

treatments. A second goal of the present study was to identify

predictors of outcome.

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> METHODS: In a university hospital, 51 of the 78 women from the

original study were reassessed 2.5 years after the end of their

treatment. They completed 1) a gynecologic examination involving the

cotton-swab test, 2) a structured interview, and 3) validated pain

and sexual functioning measures.

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> RESULTS:

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> Results from the multivariate analysis of variance conducted on the

pain measures showed a significant time main effect (P<.05) and a

significant treatment main effect (P<.01), indicating that

participants had 'less pain' at the 2.5-year follow-up than at the

previous 6-month follow-up.

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> Results from the multivariate analysis of variance conducted

on 'sexual functioning' measures showed that participants remained

unchanged between the 6-month and 2.5-year follow-up and that there

were 'no' group differences.

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> Higher pretreatment pain intensity predicted poorer outcomes at the

2.5-year follow-up for vestibulectomy (P<.01), biofeedback (P<.05),

and cognitive–behavioral therapy (P<.01). Erotophobia also predicted

a poorer outcome for vestibulectomy (P<.001).

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> CONCLUSION: Treatment gains were maintained at the 2.5-year follow-

up. Outcome was predicted by pretreatment pain and psychosexual

factors.

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> source:

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