Ramakers M J, van Lunsen H W
afd. Seksuologie en Psychosomatische Gynaecologie, Universiteit van Amsterdam/Academisch Medisch Centrum.
Ned Tijdschr Geneeskd. 1997 Nov 1;141(44):2100-5.
Vulvodynia is a puzzling disorder. Patients experience clear physical complaints of vulvar burning. Often they have consulted many physicians and tried all kinds of treatment. Vulvodynia is often caused by the vulvar vestibulitis syndrome (VVS). To detect VVS an extensive medical and psychosexual history is necessary. Thorough examination of the vaginal vestibule reveals the typical focal erythematous lesions. The aetiology of VVS is unknown. Of the many causal and perpetuating factors a sexual arousal disorder and pelvic floor hypertonia are the main ones. The psychodynamic aspects of these two core symptoms are principal issues in diagnosis and treatment of VVS. Treatment should include all physical, psychological, relational and sexual aspects of the problem. Surgical interventions should be limited to those rare cases in which an integrative approach fails to free the patient from the vicious circle of pain, anxiety and muscle tension.
外阴痛是一种令人困惑的病症。患者会经历明显的外阴灼烧等身体不适。他们常常咨询过许多医生并尝试过各种治疗方法。外阴痛通常由外阴前庭炎综合征（VVS）引起。要检测VVS，详尽的医学和性心理病史是必要的。对阴道前庭进行全面检查可发现典型的局灶性红斑病变。VVS的病因尚不清楚。在众多致病和使病情持续的因素中，性唤起障碍和盆底肌高张力是主要因素。这两个核心症状的心理动力学方面是VVS诊断和治疗中的主要问题。治疗应涵盖该问题的所有身体、心理、人际关系和性方面。手术干预应仅限于那些罕见的情况，即综合治疗方法未能使患者摆脱疼痛、焦虑和肌肉紧张的恶性循环。
