Ankara University School of Medicine, Ankara, Turkey.
Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal.
J Low Genit Tract Dis. 2024 Jan 1;28(1):64-72. doi: 10.1097/LGT.0000000000000780. Epub 2023 Nov 13.
Vulvodynia is defined as vulvar pain of at least 3 months' duration, without clear identifiable cause, which may have potential associated factors. It can have a significant impact on women's quality of life due to a combination of physical pain, emotional distress, and limited treatment options. Despite affecting a considerable number of women worldwide, the causes and underlying mechanisms of vulvodynia remain poorly understood. Given the recognized association of the vaginal microbiota with various gynecologic disorders, there has been growing interest in exploring the potential role of the vaginal microbiota in the etiology of vulvodynia. This systematic review aims to evaluate the current literature on the association between the vaginal microbiota and vulvodynia.
A systematic search of multiple databases, including PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MEDLINE, was conducted to identify relevant peer-reviewed studies up to May 12, 2023. The following search terms were used across these databases: "vulvodynia," "vestibulodynia," "vulvar vestibulitis," "microbiome," "microbiota," and "flora."
A total of 8 case-control studies were included, the quality of which was assessed using the Newcastle-Ottawa Scale. Data extraction and synthesis were performed using a standardized protocol. In most studies, no major differences were found between the vaginal bacterial composition of women with vulvodynia and that of controls. No specific bacterial taxa were consistently associated with vulvodynia. The relationship between vaginal microbiota diversity and vulvodynia remains to be fully understood.
The role of vaginal microbiota in vulvodynia, if any, remains unclear. Because of the cross-sectional nature of the included studies, it is not possible to make any causal inferences. Further research, using larger and more diverse study populations and advanced sequencing techniques, is necessary to gain a better understanding of the potential relationship between the vaginal microbiota and vulvodynia.
外阴痛定义为外阴疼痛持续至少 3 个月，无明确可识别的原因，可能存在潜在相关因素。由于身体疼痛、情绪困扰和有限的治疗选择，它会对女性的生活质量产生重大影响。尽管外阴痛影响了全球相当数量的女性，但外阴痛的病因和潜在机制仍知之甚少。鉴于阴道微生物群与各种妇科疾病的关联已得到公认，人们越来越关注探索阴道微生物群在外阴痛发病机制中的潜在作用。本系统评价旨在评估目前关于阴道微生物群与外阴痛之间关联的文献。
对多个数据库（包括 PubMed、Scopus、Web of Science、Cochrane Library 和 Ovid MEDLINE）进行了系统搜索，以查找截至 2023 年 5 月 12 日的相关同行评议研究。这些数据库中使用了以下搜索词：“外阴痛”、“外阴前庭炎”、“外阴前庭炎”、“微生物组”、“微生物群”和“菌群”。
共纳入 8 项病例对照研究，使用纽卡斯尔-渥太华量表评估其质量。使用标准化方案进行数据提取和综合。在大多数研究中，外阴痛患者和对照组之间的阴道细菌组成没有明显差异。没有特定的细菌分类群与外阴痛一致相关。阴道微生物多样性与外阴痛之间的关系仍有待充分理解。
阴道微生物群在外阴痛中的作用（如果有的话）尚不清楚。由于纳入研究的性质为横断面研究，因此无法做出任何因果推断。需要进一步的研究，使用更大和更多样化的研究人群和先进的测序技术，以更好地了解阴道微生物群与外阴痛之间的潜在关系。
