Queiroz Janice F, Aquino Antonio C Q, Sarmento Ayane C A, Siqueira Beatriz B, Medeiros Heitor D, Falsetta Megan L, Maurer Tracey, Gonçalves Ana Katherine
Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
Faculty of Medicine, Federal University of Rio Grande do Norte, Natal, Brazil.
J Low Genit Tract Dis. 2024 Jul 1;28(3):264-275. doi: 10.1097/LGT.0000000000000822. Epub 2024 May 2.
We set out to identify the psychosocial factors associated with vulvodynia and the effects on sexuality, mental health, and quality of life.
PubMed, LILACS, Embase, CINAHL, Web of Science, Scopus, and PsycINFO were searched in August 2023. Two authors selected and extracted the data independently. The risk of bias was assessed using the Newcastle-Ottawa Scale for Observational Studies. To rank the strength of evidence, the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) approach was utilized.
A total of 3,182 articles were identified. Twenty-two observational studies (8 cohorts and 14 case-controls) met the eligibility criteria and were included, comprising 2,624 patients. Vulvodynia has been associated with psychological factors (anxiety and depression) and social factors (childhood exposure to physical and sexual abuse, posttraumatic stress, and domestic abuse). Concerning sexual function, the most frequent outcomes were dyspareunia and sexual dysfunction. Only one study assessed quality of life, which showed that women with chronic vulvar pain had greater difficulty performing physical activities and experienced negative moods and feelings. The assessment of the risk of bias showed that the average quality of studies was good to excellent. However, the studies failed to select the nonexposed cohort or control group to describe the results, and often, the study population was rather small, which made it impossible to carry out a meta-analysis.
The certainty of evidence for the associations between anxiety and depression, vulvodynia, and sexual functioning suggests that combating these factors could improve overall quality of life in vulvodynia patients.
我们旨在确定与外阴痛相关的心理社会因素及其对性功能、心理健康和生活质量的影响。
于2023年8月检索了PubMed、LILACS、Embase、CINAHL、Web of Science、Scopus和PsycINFO。两位作者独立选择并提取数据。使用纽卡斯尔-渥太华观察性研究量表评估偏倚风险。为了对证据强度进行排名，采用了推荐分级评估、制定和评价工作组（GRADE）方法。
共识别出3182篇文章。22项观察性研究（8项队列研究和14项病例对照研究）符合纳入标准并被纳入，共涉及2624例患者。外阴痛与心理因素（焦虑和抑郁）以及社会因素（童年期遭受身体和性虐待、创伤后应激和家庭虐待）有关。关于性功能，最常见的结果是性交困难和性功能障碍。仅有一项研究评估了生活质量，结果显示慢性外阴疼痛的女性在进行体育活动时困难更大，且经历负面情绪和感受。偏倚风险评估表明，研究的平均质量良好至优秀。然而，这些研究未能选择未暴露队列或对照组来描述结果，而且研究人群往往较小，这使得无法进行荟萃分析。
焦虑和抑郁、外阴痛以及性功能之间关联的证据确定性表明，应对这些因素可能会改善外阴痛患者的整体生活质量。
