Patients' assessments of a superficial modified vestibulectomy for vestibulodynia

OBJECTIVE: To Assess long-term outcomes of surgical treatment of vestibulodynia by reporting patients' tabulated questionnaire responses. STUDY DESIGN: Between 1988 and 2006, 133 subjects underwent modified superficial vestibulectomies. At 4 time intervals, portions of the expanding cohort were queried with a mailed questionnaire. Results were compared to the clinical findings. Questionnaires had closed questions, ranked and non-ranked, as well as open ques-tions and visual analogue scales. Percentages were calculated by SPSS statistical software. RESULTS: A total of 119 women (89%) returned questionnaires, allowing a mean follow-up interval of 2.8 years; 68% reported that dyspareunia was cured completely, and for 24% it was lessened. Twenty-two percent said they perceived a different pain after surgery, many identifying it as muscular. Eighty-seven percent said they would have the procedure again. Qualitative responses revealed the importance of physical therapy, the complexities of pain issues, the toll on emotions and relationships and suggestions for more education of health practitioners and women generally about this entity. CONCLUSION: A large majority of women who underwent superficial vestibule surgery for vestibulodynia found it quite acceptable and instrumental in treating dyspareunia. Many wished they had had it sooner. Individualized, superficial surgery is very effective and should not be withheld if short-term medical and physical therapy have proven to be incomplete therapies.