PREVALENCE AND ETIOLOGICAL PREDICTORS OF VULVODYNIA

外阴痛的患病率和病因预测因素

• 批准号: 6618001
• 负责人: BERNARD L HARLOW
• 金额: $ 43.45万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-29 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6618001
• 关键词: birth injury; clinical research; disease /disorder etiology; epidemiology; female; female reproductive system disorder; female reproductive system disorder diagnosis; human middle age (35-64); human subject; irritation /irritant; pain; sex abuse; vagina disorder; women's health; young adult human (21-34)

DESCRIPTION (Adapted from the applicant's description): Vulvodynia is a syndrome of unexplained vulvar itching, burning, and/or pain that causes major physical and psychological distress. It is a diagnosis of exclusion when vulvar discomfort becomes chronic over many months and the presence of any other remediable cause, such as infection or dermatitis, is ruled out. The two major subtypes of vulvodynia -- generalized vulvar dysesthesia and vestibulodynia -- are often misclassified. Few descriptive or etiologic epidemiological studies have been performed. Thus, the prevalence and incidence in the general population is unknown and no preventable exposures have been identified. A recent NIH sponsored consensus conference stressed the need to determine the prevalence of vulvodynia and conduct population-based observational studies to identify modifiable risk factors. The applicant has conducted a population-based prevalence survey in more than 400 women that achieved a 70% response rate and found that 18% of women reported a lifetime history of chronic vulvar symptoms that lasted three months or longer. Approximately 8% of all women surveyed were currently experiencing these symptoms. In addition, the applicant conducted a pilot case-control study of 31 women diagnosed with either dysesthetic vulvodynia or vestibulodynia, or a combination of the two within the last five years and compared them to 31 similarly aged healthy women identified from the general population. Cases were, on average, three times more likely to report medical treatments or surgical procedures for conditions that may have influenced perineal pain, or a greater frequency of condom use and use of talcum powder in the genital area that may have lead to mucosal abrasion and inflammation. The applicant now proposes to survey 16,000 women 20-59 years of age from the general population to estimate the age-specific prevalence of vulvodynia. From this sample, the applicant will identify 400 cases of vulvodynia, verified through a two-step screening process, and a sample of 400 frequency matched age and county of residence controls. Structured interviews will assess a wide spectrum of exposures related to trauma. A subsample of 80 cases and 80 controls will receive a clinical examination to confirm the presence or absense of vulvodynia, and also will provide a vaginal lavage and vulvar swab specimen for the assessment of cytokines and the culturing of microbiological organisms. The applicant hypothesizes that various types of vulvar trauma may precede the spontaneous and evoked vulvar pain experienced by women with vulvodynia and that vulvodynia may be a variant of a specific type of Complex Regional Pain Syndrome that is consistent with sensory disturbances such as mechanical allodynia.

描述（改编自申请人的描述）：外阴痛是一个 无法解释的外阴瘙痒，燃烧和/或疼痛的综合征，导致重大 身体和心理困扰。当这是排除的诊断 外阴不适在多个月内变得慢性，并且存在 排除了其他可补救原因，例如感染或皮炎。两个 外阴痛的主要亚型 - 普遍的外阴感觉和 前庭 - 经常被错误分类。很少的描述性或病因 已经进行了流行病学研究。因此，患病率和 普通人群的发病率是未知的，没有可预防的暴露 已经确定了。 NIH最近赞助的共识会议强调了 需要确定外阴痛的患病率并进行基于人群的患病率 观察性研究以识别可修改的危险因素。 申请人在超过的 400名妇女达到了70％的缓解率，发现18％的女性 报道了慢性外阴症状的终生历史，持续了三个 几个月或更长时间。目前约有8％的妇女中有8％ 经历这些症状。此外，申请人进行了飞行员 病例对照研究的31名妇女被诊断出患有发热性外阴痛或 前五年内的前骨动肌，或者在过去五年内的组合 将她们与从一般确定的31个同样老化的健康女性进行了比较 人口。病例平均报告医疗的可能性是 治疗或外科手术可能影响的状况 会阴疼痛，或更大的避孕套使用和使用滑石粉 在生殖区域，可能导致粘膜磨损和炎症。 申请人现在建议调查16,000名20-59岁的女性 一般人群估计外阴痛的特异性患病率。从 该样本，申请人将识别400例外阴痛，经过验证 通过两步筛选过程，并匹配400个频率的样本 年龄和居住控制权。结构化访谈将评估广泛的 与创伤有关的暴露范围。 80例和80例的子样本 控件将接受临床检查以确认存在或 缺乏外阴痛，还将提供阴道灌洗和外阴拭子 评估细胞因子和微生物培养的标本 有机体。申请人假设各种各样的外阴创伤可能 在女性经历的自发和唤起的外阴痛之前 外阴痛和外阴痛可能是特定类型的复合物的变体 区域疼痛综合征与感觉障碍一致 机械性异常。