Symptoms of vulvar vestibulitis

Many people are not particularly familiar with vulvar vestibulitis. This is a chronic and persistent inflammatory condition characterized by the appearance of erythema in the vestibule of the female vulva. There is a feeling of pressure when touched, which often causes pain. There are many causes, such as allergies, bacteria, and viral infections, which may cause this phenomenon. It is easy to form a burning sensation, itching symptoms, and even rashes or blisters.

Inflammation of the vulva skin caused by contact with irritants or allergens. Inflammation of the vulva may occur if the vulva comes into contact with strong acid and alkali disinfectants, vaginal douches, some dyed clothing, or penicillin and other allergic drugs. After the vulva comes into contact with some irritating substances, the contact area will feel burning, pain, and itching. Examination may reveal local skin flushing, rash, and blisters. In severe cases, necrosis and ulcers may occur. Allergic dermatitis occurs in the area that has come into contact with the allergic substance.

Diagnosis is not difficult based on medical history and clinical manifestations. The cause must be eliminated as soon as possible, and irritating substances such as soap and scratching must be avoided. For patients with severe symptoms of allergic dermatitis, oral administration of cyproheptadine, astemizole or corticosteroids can be used, the local area can be washed with normal saline or cold compressed with 3% boric acid solution, and then calamine lotion can be applied. If there is secondary infection, apply antibiotic ointment such as chloramphenicol ointment or 1% neomycin ointment.

Because the cause of the disease is unclear, the treatment effect is not ideal. For patients with mild lesions or short course of illness, drug treatment can be used; for patients with severe lesions or those who are not responsive to drug treatment, surgical treatment can be used.

1. Drug treatment: Apply 1% hydrocortisone ointment topically and 2% to 5% lidocaine solution topically to relieve discomfort during sexual intercourse. When the above treatment is ineffective or the lesion is severe, high-efficiency corticosteroids such as 0.025% fluocinolone acetonide or 0.1% triamcinolone acetonide ointment can be used for external use.

Other treatments include warm water sitz baths and liquid paraffin to lubricate the vestibule before intercourse. Local or intramuscular injection of interferon α has a certain therapeutic effect with an effective rate of 50%. Some patients benefit from antihistamines. Since tricyclic antidepressants have central analgesic effects and are also effective for secondary depression, they can be used. The efficacy of antibiotics is uncertain, such as oral imidazole antifungal drugs such as metronidazole, which are ineffective.

Vestibulectomy is to remove the mucosa of the vestibule pain area, and then cover it with a part of the vaginal mucosa. Partial vestibulectomy and total vestibulectomy can be selected according to the condition. It has been reported that laser or surgical removal of the vestibular gland distribution area can help improve symptoms in some patients, but there is a lack of long-term follow-up research data.

Explain to the patient that vestibulitis is a recognized disease, not a primary psychological problem for which there is no effective treatment. Patients may be advised to use soap alternatives and avoid soapy or bubble baths. Most people who follow the doctor's instructions do well, and their symptoms decrease or disappear over time.