Abstract
Surgical resection of the vestibule is the treatment of choice when medical therapy of vulvar vestibulitis fails. We wished to determine whether a limited form of vestibulectomy could adequately treat the symptoms of vulvar vestibulitis limited to the posterior vestibule. A series of 27 patients with vulvar vestibulitis limited to the posterior vestibule were treated with modified vestibulectomy by the lead author in a private practice setting. Results were evaluated by calculation of standard error of the mean and 95% confidence intervals where appropriate. The procedure was associated with no surgical complications. Fourteen (52%; 95% CI 33.1, 70.7) of patients attained an immediate complete response with follow-up of up to 14 years. Five (19%; 95% CI 3.8, 33.2) of patients had no improvement in symptoms following surgery. Symptoms recurred in 8 (30%; 95% CI 12.5, 46) of patients within 2 years of treatment. Recurrent pain required repeat surgery or topical therapy to attain a satisfactory result. Modified vestibulectomy produces only a modest likelihood of relieving symptoms of posterior vulvar vestibulitis.
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