Lev-Sagie Ahinoam, Witkin Steven S
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
F1000Res. 2016 Oct 26;5:2581. doi: 10.12688/f1000research.9603.1. eCollection 2016.
Vulvodynia refers to pain in the vulva of at least 3 months' duration in the absence of a recognized underlying cause. Provoked, localized vestibulodynia is the term used to describe superficial pain confined to the vulvar vestibule, provoked by touch. This review will focus on provoked vestibulodynia with regard to its suggested causative factors and will discuss the role of inflammation, vulvovaginal infections, mucosal nerve fiber proliferation, hormonal associations, central pain mechanisms, pelvic floor muscle dysfunction, and genetic factors. Clinical observations, epidemiological studies, and data from basic research emphasize the heterogeneity of vulvar pain syndromes. There is a critical need to perform prospective, longitudinal studies that will allow better diagnostic criteria and subgrouping of patients that would lead to improvements in our understanding of provoked vestibulodynia and its treatment.
外阴痛是指在没有公认的潜在病因的情况下，外阴疼痛持续至少3个月。激发性局限性前庭痛是用于描述局限于外阴前庭的浅表疼痛，由触摸诱发。本综述将聚焦于激发性前庭痛的潜在致病因素，并讨论炎症、外阴阴道感染、黏膜神经纤维增生、激素关联、中枢性疼痛机制、盆底肌肉功能障碍和遗传因素的作用。临床观察、流行病学研究以及基础研究数据均强调外阴疼痛综合征的异质性。迫切需要开展前瞻性纵向研究，以制定更好的诊断标准并对患者进行亚组划分，从而增进我们对激发性前庭痛及其治疗的理解。
