Tuma Ruba, Bornstein Jacob
Department of Obstetrics and Gynecology, Western Galilee Hospitalm, Nahariya, The Bruce Rappaport Faculty of Medicine, Technion, Haifa.
Harefuah. 2006 Mar;145(3):215-8, 244.
In recent years there has been increasing awareness of chronic vulvar pain, both in the medical and lay communities. The etiology of vulvar pain is largely unknown. Furthermore, there is no worldwide consensus regarding the terminology and classification of this condition, which makes it difficult to compare the results of different treatments. In 2003, following more than three decades of uncertainty, the terminology and classification of vulvar pain was re-established.
To review the development of nomenclature for vulvar pain and the increasing understanding of its pathophysiology.
A literature review was conducted of articles related to the nomenclature of vulvar pain and vulvar diseases, and a summary of the world congresses of the International Society for the Study of Vulvovaginal Disease (ISSVD) from 1976 until 2003.
In 1976, members of the ISSVD recognized vulvar pain as a unique entity, and called it burning vulva syndrome. In 1985, the ISSVD renamed this disorder "Vulvodynia" and classified it into two clinically distinctive subsets: dysesthetic vulvodynia and vestibulitis. However, recent studies failed to confirm an inflammatory pathogenesis, and the term vestibulitis was replaced by the term vestibulodynia at the 1999 ISSVD congress. In 2003, the ISSVD reviewed the terminology and used the term vulvodynia, which is further classified as either generalized or localized, and by the presence or absence of stimulus for pain.
The re-establishment of the ISSVD terminology and classification in 2003 will help physicians and researchers improve the understanding of chronic idiopathic vulvar pain, and develop effective treatments.
近年来,医学界和普通大众对慢性外阴疼痛的认识都在不断提高。外阴疼痛的病因很大程度上尚不清楚。此外,对于这种疾病的术语和分类,全球尚未达成共识,这使得不同治疗结果难以比较。2003年,在经历了三十多年的不确定性之后,外阴疼痛的术语和分类得以重新确立。
回顾外阴疼痛命名法的发展以及对其病理生理学认识的不断加深。
对与外阴疼痛和外阴疾病命名相关的文章进行文献综述,并总结1976年至2003年国际外阴阴道疾病研究学会(ISSVD)世界大会的情况。
1976年,ISSVD成员将外阴疼痛视为一种独特的病症,并称之为灼痛性外阴炎综合征。1985年,ISSVD将这种疾病重新命名为“外阴痛”,并将其分为两个临床特征不同的亚组:感觉异常性外阴痛和前庭炎。然而,最近的研究未能证实炎症发病机制,在1999年ISSVD大会上,前庭炎这一术语被前庭痛所取代。2003年,ISSVD对外阴疼痛术语进行了修订,使用外阴痛这一术语,进一步分为广泛性或局限性,并根据是否存在疼痛刺激进行分类。
2003年ISSVD术语和分类的重新确立将有助于医生和研究人员更好地理解慢性特发性外阴疼痛,并开发有效的治疗方法。