Abstract：
OBJECTIVE: To evaluate the effectiveness and complication rate of vestibulectomy for vulvodynia.
METHODS: A retrospective cohort study in a teaching and university hospital analyzing patients with vulvodynia with insufficient response to conservative treatment who underwent a vestibulectomy. Data from 114 consecutive vestibulectomy procedures done between September 2009 and October 2018 were retrospectively analyzed. All procedures were performed by the same surgeon.The primary outcome was difference in pain scale (6-point Q-tip test, Nociceptive Rating Scale) between preoperative consultation, postoperative visit, and last follow-up consultation. The secondary outcome was surgical complications, such as wound dehiscence and hematoma.
RESULTS: Complete data were available for 80 patients. There was a significant reduction in median pain scores of between 65% and 80% on all 6 evaluated vestibular points during Q-tip tests. The median follow-up was 21 months, ranging from 1 to 92 months (interquartile range [IQR]). Overall, 75% of patients needed no further treatment at the end of the follow-up period. In 22.6% (18/80), a limited wound dehiscence was noted. No other complications were reported nor were there any cases of worsening of the complaints.
CONCLUSIONS: In this retrospective cohort study, a significant pain reduction occurred after vestibulectomy in patients who were not responding to conservative treatment. The complication rate of this surgical procedure is low. Vestibulectomy seems to be an effective technique for management of vulvodynia.
METHODS: A retrospective cohort study in a teaching and university hospital analyzing patients with vulvodynia with insufficient response to conservative treatment who underwent a vestibulectomy. Data from 114 consecutive vestibulectomy procedures done between September 2009 and October 2018 were retrospectively analyzed. All procedures were performed by the same surgeon.The primary outcome was difference in pain scale (6-point Q-tip test, Nociceptive Rating Scale) between preoperative consultation, postoperative visit, and last follow-up consultation. The secondary outcome was surgical complications, such as wound dehiscence and hematoma.
RESULTS: Complete data were available for 80 patients. There was a significant reduction in median pain scores of between 65% and 80% on all 6 evaluated vestibular points during Q-tip tests. The median follow-up was 21 months, ranging from 1 to 92 months (interquartile range [IQR]). Overall, 75% of patients needed no further treatment at the end of the follow-up period. In 22.6% (18/80), a limited wound dehiscence was noted. No other complications were reported nor were there any cases of worsening of the complaints.
CONCLUSIONS: In this retrospective cohort study, a significant pain reduction occurred after vestibulectomy in patients who were not responding to conservative treatment. The complication rate of this surgical procedure is low. Vestibulectomy seems to be an effective technique for management of vulvodynia.
摘要：
目的：评价前庭切除术治疗外阴痛的疗效及并发症发生率。
方法：一项在教学和大学医院进行的回顾性队列研究，分析了接受前庭切除术后对保守治疗反应不足的外阴痛患者。回顾性分析了2009年9月至2018年10月进行的114例连续前庭切除术的数据。所有手术均由同一外科医生进行。主要结果是疼痛量表的差异（6点Q-tip测试，伤害性评定量表）术前咨询之间，术后访视,以及最后的后续咨询。次要结果是手术并发症，如伤口裂开和血肿。
结果：可获得80例患者的完整数据。在Q-tip测试期间，所有6个评估的前庭点的中位疼痛评分显着降低了65％至80％。中位随访时间为21个月,1至92个月不等(四分位数范围[IQR])。总的来说,75％的患者在随访期结束时无需进一步治疗。在22.6%（18/80）中，注意到有限的伤口裂开。没有报告其他并发症，也没有任何投诉恶化的病例。
结论：在这项回顾性队列研究中，对于保守治疗无效的患者,前庭切除术后疼痛显著减轻.这种手术的并发症发生率很低。前庭切除术似乎是治疗外阴痛的有效技术。
方法：一项在教学和大学医院进行的回顾性队列研究，分析了接受前庭切除术后对保守治疗反应不足的外阴痛患者。回顾性分析了2009年9月至2018年10月进行的114例连续前庭切除术的数据。所有手术均由同一外科医生进行。主要结果是疼痛量表的差异（6点Q-tip测试，伤害性评定量表）术前咨询之间，术后访视,以及最后的后续咨询。次要结果是手术并发症，如伤口裂开和血肿。
结果：可获得80例患者的完整数据。在Q-tip测试期间，所有6个评估的前庭点的中位疼痛评分显着降低了65％至80％。中位随访时间为21个月,1至92个月不等(四分位数范围[IQR])。总的来说,75％的患者在随访期结束时无需进一步治疗。在22.6%（18/80）中，注意到有限的伤口裂开。没有报告其他并发症，也没有任何投诉恶化的病例。
结论：在这项回顾性队列研究中，对于保守治疗无效的患者,前庭切除术后疼痛显著减轻.这种手术的并发症发生率很低。前庭切除术似乎是治疗外阴痛的有效技术。
