Merlino Lucia, Titi Luca, Pugliese Francesco, D'Ovidio Giulia, Senatori Roberto, Rocca Carlo Della, Piccioni Maria Grazia
Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, 00161 Rome, Italy.
Pharmaceuticals (Basel). 2022 Dec 5;15(12):1514. doi: 10.3390/ph15121514.
Background: Vulvodynia is defined in this international consensus as persistent vulvar pain that occurs for >3 months without an identifiable cause and with several potential associated factors. At present there is no univocal consensus in the therapeutic treatment of vulvodynia. The methods of intervention are based on various aspects including, above all, the management of painful symptoms. Methods: a research on scientific database such as “Pubmed”, “Medline Plus”, “Medscape” was conducted, using the words “women’s genital pain” and “vulvodynia” for the review of the scientific evidence on the assessment and treatment of women’s genital pain. Results: Among the drugs with pain-relieving action, the most effective in the treatment of vulvodynia would seem to be those with antidepressant and anticonvulsant action, even if their mechanisms of action are not known and there are still insufficient studies able to demonstrate their real validity. Among the least effective are non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. However, the ideal would seem to use a combined treatment with multiple types of drugs. Conclusions: Future studies are needed to draw up a unique therapeutic action plan that considers the stratification of patients with vulvodynia and the variability of the symptom.
在本国际共识中，外阴痛被定义为持续3个月以上且无明确病因并伴有多种潜在相关因素的外阴持续性疼痛。目前，在外阴痛的治疗方面尚无统一的共识。干预方法基于多个方面，最重要的是疼痛症状的管理。方法：利用“女性生殖器疼痛”和“外阴痛”等词汇，对“Pubmed”“Medline Plus”“Medscape”等科学数据库进行检索，以回顾关于女性生殖器疼痛评估和治疗的科学证据。结果：在具有止痛作用的药物中，治疗外阴痛最有效的似乎是具有抗抑郁和抗惊厥作用的药物，尽管其作用机制尚不清楚，且仍有不足的研究能够证明其实际有效性。最无效的药物是非甾体抗炎药（NSAIDs）和皮质类固醇。然而，理想的做法似乎是采用多种药物联合治疗。结论：需要开展进一步研究，以制定一个独特的治疗行动计划，该计划应考虑外阴痛患者的分层情况以及症状的变异性。
