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外阴痛:临床与方法学研究挑战及推荐解决方案的思考

Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions.

作者信息

Corsini-Munt Serena, Rancourt Kate M, Dubé Justin P, Rossi Meghan A, Rosen Natalie O

机构信息

Department of Psychology and Neuroscience.

Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS, Canada.

出版信息

J Pain Res. 2017 Oct 9;10:2425-2436. doi: 10.2147/JPR.S126259. eCollection 2017.

Abstract

Vulvodynia, an idiopathic chronic vulvar pain, is a prevalent genital pain condition that results in significant impairment to sexual, relational, and psychological functioning of affected women and their romantic partners. Despite its high prevalence, there remain gaps in knowledge and health care access for women coping with vulvodynia, given its varied clinical presentation and no widely accepted treatment protocol. The past several decades have seen important advancements in understanding vulvodynia and developing effective treatments; however, progress has been impeded due to clinical and methodological challenges in conducting research with this vulnerable population. This review presents a brief overview of vulvodynia correlates, consequences, etiology, and treatment, and then turns its attention to considering the clinical and methodological challenges that hinder vulvodynia research. Identifying these barriers alongside potential mitigating solutions is essential to developing empirically supported treatments for all women affected by vulvodynia, across all age and minority groups. Potential solutions will require researchers to broaden eligibility criteria, examine subgroups of women, and expand definitions of treatment outcomes, and may be best facilitated by more active collaboration among research groups and across relevant disciplines. Engagement in these solutions may contribute to more representative findings and the development and dissemination of empirically based treatment options for this complex pain condition.

摘要

外阴痛是一种特发性慢性外阴疼痛,是一种常见的生殖器疼痛病症,会对受影响女性及其伴侣的性、人际关系和心理功能造成严重损害。尽管其患病率很高,但由于其临床表现多样且缺乏广泛接受的治疗方案,在应对外阴痛的女性的知识和医疗保健获取方面仍存在差距。在过去几十年里,对外阴痛的理解和有效治疗方法的开发取得了重要进展;然而,由于对这一弱势群体进行研究时面临临床和方法学上的挑战,进展受到了阻碍。本综述简要概述了外阴痛的相关因素、后果、病因和治疗方法,然后将注意力转向考虑阻碍外阴痛研究的临床和方法学挑战。识别这些障碍以及潜在的缓解解决方案对于为所有受外阴痛影响的女性(不分年龄和少数群体)开发基于实证的治疗方法至关重要。潜在的解决方案将要求研究人员扩大纳入标准,研究女性亚组,并扩展治疗结果的定义,并且可能通过研究小组之间以及跨相关学科的更积极合作得到最好的促进。参与这些解决方案可能有助于获得更具代表性的研究结果,并为这种复杂的疼痛病症开发和推广基于实证的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fc6/5640408/d923766929f0/jpr-10-2425Fig1.jpg

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