Systematic review and meta-analysis of the effects of treatment modalities for vestibulodynia in women

Faustino R. Pérez-López, Juan Bueno-Notivol, Adrian V. Hernandez, Pedro Vieira-Baptista, Mario Preti, Jacob Bornstein

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To quantify the effects of available treatments of vestibulodynia. Methods: Systematic review of randomised controlled trials (RCTs) in six search engines until December 2018, comparing any intervention vs. placebo or sham in women with vestibulodynia. Primary outcome was dyspareunia assessed with visual analogue (VAS) or numeric rating (NRS) scales. Secondary outcomes were daily vestibular symptoms (DVS), McGill Pain Questionnaire (MPQ) and Index of Sexual Satisfaction (ISS). Effects were described as mean differences (MDs) with their 95% confidence intervals (CIs). Traditional and frequentist network meta-analyses (NMA) were performed using random effect models. Results: Four RCTs (n = 275) were included evaluating vaginal cream of conjugated oestrogens, oral desipramine with or without topical lidocaine, topical lidocaine, laser therapy and transcranial direct current. In traditional MA, interventions did not reduce dyspareunia (MD = 0.08; 95%CI = −0.49 to 0.64), DVS (MD = −0.04; 95%CI = −0.31 to 0.24; 4 interventions), or MPQ (MD = −0.17; 95%CI = −2.16 to 1.81; 4 interventions). ISS was significantly improved (MD = −5.14; 95%CI = −9.52 to −0.75). In NMA, oral desipramine with or without lidocaine significantly improved ISS vs. other treatments. Conclusions: Several existing interventions were not associated with improvements in vestibulodynia. There only was improvement of sexual function with oral desipramine with or without lidocaine.

Original languageAmerican English
Pages (from-to)337-346
Number of pages10
JournalEuropean Journal of Contraception and Reproductive Health Care
Volume24
Issue number5
DOIs
StatePublished - 3 Sep 2019

Keywords

  • Dyspareunia
  • sexual function
  • vestibulodynia
  • vulvar pain
  • vulvodynia

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