In the entrance of vagina, thin and delicate skin tissue which is including the hymen floor is known as ‘vestibulm’ or ‘vulvar vestibulm’. Excessive sensitivity of this region in some women may cause pain (dyspareunia) complaints during intercourse.
Women suffering from Vulvar Vestibulitis problem describe the deep pain during sexual intercourse in different ways as ‘as if that area is torn, cut with a knife or an open wound is rubbed with salt’.
Vulvar vestibulitis which means the inflammation of vestibular area is also known as ‘Vulvar Vestibulitis Syndrome’.
It is a common sexual health problem which is frequently seen in women, but unfortunately many gynecologists ignore this problem during gynecological examination.
It can easily be diagnosed with ‘cotton-tipped test’. Patients feel a sharp pain when the cotton tipped rod is gently touched into vestibulm. During the examination, sometimes a slight redness in the vestibular area can be seen.
The most common causes are ‘vaginitis’, which are frequent vaginal infections. Fungal infections, bacterial vaginosis-type infections may cause skin tissue irritation. Thus, the tissue may become more sensitive. HPV infections, on the other hand, may also pave the way for the problem. It has been reported that urate crystals in urine may also cause chronic irritation and vestibulitis.
Chronic irritation substances should be avoided. Such reasons as using scented toilet papers, tampon, pads and skinny jeans may cause irritation in some women.
Washing the inner side of the vaginal canal with water (vaginal shower),washing the outer side with soap or shampoo may also disrupt the PH value of this area, leading to the growth of opportunistic microbes and recurrent genital infections.
Only water and PH-consistent non-allergenic intim gels or shampoos should be used in order to clean the outer genital area.
Vulvar vestibulitis syndrome is the cause of dyspareunia and vaginismus in women. A large number of women who have this problem experience feeling of pain, aching, burning, stinging in the intercourse with their partners. Problems of non-orgasm (anorgasmia),vaginal dryness and sexual reluctance can also be seen when untreated. It may also lead to frequent cystitis and urinary tract infections after intercourse. There are women who have not had sexual intercourse with their partner for years because of this problem.
Most of the patients with vestibulitis problems apply to gynecologist physicians with complaints of pain and sexual reluctance. As with vaginismus, a part of the patients cannot have any sexual intercourse with their partners.
Firstly, the causes of chronic irritation are tried to be determined. The person is enabled to move away from these irritant substances. In patients with vaginitis (vaginal infection),this problem is resolved with medication treatments. If the complaint still continues, some of the non-surgical or surgical procedures can be needed.
Non-surgical procedures: It can be considered for mild vestibulitis patients.
Sometimes a few methods are needed as a combination.
For the success of treatment, procedures may be required to be repeated. But, the aim is to reduce tissue sensitivity by enhancing collagen connective tissue.
Surgical treatments: Surgical procedures are more effective according to our own experience. With the surgical operation, called as ‘Vulvar vestibulectomy’, skin tissue in this area is removed as a thin later. Removed part of vulvar mucosa (biopsy) should definitely be sent for pathology.
It is not difficult, but a very specific (special) operation. This operation should be performed by a trained gynecologist. Otherwise undesirable results may occur. The average duration of the operation is 25-30 minutes. It can also be performed with mild sedation anesthesia or local anesthetic creams administration. One day after the operation, it is possible to return to daily life.
Patients with vulvar vestibulitis syndrome may also need sexual therapy. Therefore, according to the approach in our clinic, patients are required to come to the sexual therapy after 4-5 weeks. The problem of vulvar vestibulitis can be solved today with the managements by experienced gynecologists.
Copyright 2022 Assoc. Prof. Süleyman ESERDAĞ, MD. All Rights Reserved. Legal Warning