The additional value of transcutaneous electric nerve stimulation (TENS) to the multidimensional treatment for provoked vestibulodynia.

Vallinga, M.S. (2013) The additional value of transcutaneous electric nerve stimulation (TENS) to the multidimensional treatment for provoked vestibulodynia. thesis, Medicine.

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Abstract

Rationale: Since 2009, women with provoked vestibulodynia (PVD) are offered transcutaneous electrical nerve stimulation (TENS) in addition to a multidimensional treatment protocol. Since PVD is a chronic pain disorder, TENS might reduce these women’s vulvar pain. Aim: The aim of this study is to evaluate the effect of TENS, in addition to the multidimensional treatment, on vulvar pain, sexual functioning and sexual related personal distress in women with PVD. Secondary aim is to assess the effect of TENS, in addition to the multidimensional treatment, on the number of vestibulectomies in this patient population. Methods: Four questionnaires, to measure vulvar pain, sexual functioning and sexual related personal distress, were completed at baseline (T1), post-treatment (T2) and at follow-up (T3). The following questionnaires were used; vulvar pain (McGill Pain Questionnaire (MPQ) and VAS) sexual functioning (FSFI), sexually related personal distress (FSDS). An additional questionnaire assessed socio-demographic variables, i.e. resumption of intercourse, medical history, and whether or not subjects would recommend the treatment to other women with PVD. Results: A total of 32 women with PVD were included. All patients underwent TENS treatment in a domiciliary setting in addition to a multidimensional approach. The mean age of women was 27 years (SD 5.5), and the mean duration of PVD symptoms was 5 years (SD 4.2). Data were collected prior to treatment with TENS, at the end of the treatment (T2) and, by mail, 24 months post treatment (T3).Vulvar pain VAS scores post-treatment (mean 3.7; SD 2.4) were significantly lower compared to baseline (mean 7.4; SD 2.1) level. At follow-up, vulvar pain scores (mean 4.4; SD 2.6) were still significantly lower compared to baseline scores. Post-treatment, sexual functioning scores improved significantly, i.e. 45% of the women reached a score above the cut-off score for sexual dysfunction. Mean scores of sexual functioning lowered slightly at follow-up, but remained higher than at baseline (p=0.08). Of the women who underwent the multidimensional treatment followed by TENS, 5% have undergone a vestibulectomy. In comparison to 23% in the population of women with PVD, who received a multidimensional approach without TENS (1). Conclusion: The addition of TENS to the multidimensional treatment resulted in a significant reduction in vulvar pain with a stable long-term effect and a reduction in the number of vestibulectomies. These results support our hypothesis that TENS treatment is a valuable addition to the multidimensional treatment of PVD.

Item Type:	Thesis (Thesis)
Supervisor name:	Weijmar Schultz, Prof. dr. W.C.M.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:53
Last Modified:	25 Jun 2020 10:53
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1400

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