Vestibular Nerve Fiber Proliferation in Vulvar Vestibulitis Syndrome

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 91; no. 4; pp. 572 - 576
• Main Authors: Weström, Lars V, Willén, Roger
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1998; The American College of Obstetricians and Gynecologists; Elsevier Science
• Subjects: Adolescent; Adult; Biological and medical sciences; Dyspareunia - etiology; Dyspareunia - pathology; Dyspareunia - surgery; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Nerve Fibers - pathology; Non tumoral diseases; Syndrome; Vulva - innervation; Vulva - surgery; Vulvitis - pathology; Vulvitis - surgery; Human; Immunohistochemistry; Cell proliferation; Nervous system diseases; Pathophysiology; Hyperplasia; Vulvitis; Vestibule; Female genital diseases; Pathology; Pain; Histopathology; Treatment; Surgery; Posterior; Vulvar diseases; Female; Nerve fiber; Vulvectomy
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(97)00719-9

Objective: To evaluate nerve fiber density in vestibular specimens from women operated upon for vulvar vestibulitis. Methods: Forty-seven women with vulvar vestibulitis syndrome underwent modified posterior vestibulectomies. Vestibular specimens were analyzed after being stained for S-100 neural tissue protein. Women were followed up for 2 years. Results: In specimens from 44 of 47 patients, the densities and numbers of nerve fibers per square unit in the preparations were greater than those in specimens from six control women. In the patients, a statistically significant linear correlation was found between inflammation and nerve bundle density in the preparations (Spearman rank correlation coefficient rs = .41; P = .005). There were no signs of infectious etiology in any preparation. No or slight postoperative dyspareunia was reported by 38 of 42 women after 6 months, 36 of 39 after 12 months, and 26 of 28 after 24 months. Conclusion: Vestibular neural hyperplasia may provide a morphologic explanation of the pain in vulvar vestibulitis syndrome.