Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis.

Abstract

OBJECTIVE:

To assess the effectiveness of nightly application of 5% lidocaine ointment for treatment of vulvar vestibulitis.

METHODS:

Over 17 months, we assessed women presenting to our pain clinic for evaluation of introital pain; 61 women met the criteria for vulvar vestibulitis and participated in a treatment trial. We measured daily pain and intercourse-related pain using a 100-mm visual analog scale. We compared ability to have intercourse and pain ratings before and after treatment, and investigated whether prior treatment or gynecologic comorbidities predicted response to treatment.

RESULTS:

After a mean of 7 weeks of nightly treatment, 76% of women reported ability to have intercourse, compared with 36% before treatment (P =.002). Intercourse-related pain score was 39.11 (95% confidence interval [CI] 30.39, 47.83) points lower after treatment (P <.001), with a decrease of 10.37 (95% CI 3.53, 17.21) points in daily pain score (P =.004). We found no association between response to prior episodic use of lidocaine and response to nightly therapy with lidocaine ointment. Few patient characteristics predicted response to treatment; however, women with interstitial cystitis and other vulvar conditions were least likely to benefit.

CONCLUSION:

Long-term, nightly application of 5% lidocaine ointment shows promise as a treatment for management of vulvar vestibulitis; a randomized, double-blind, clinical trial is warranted.

• Authors: Denniz A Zolnoun, Katherine E Hartmann, John F Steege
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 102 Issue 1 Pg. 84-7 (Jul 2003) ISSN: 0029-7844 [Print] United States
• PMID: 12850611 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Ointments
• Lidocaine

Topics

• Administration, Topical
• Adult
• Cohort Studies
• Confidence Intervals
• Drug Administration Schedule
• Dyspareunia (complications, diagnosis, drug therapy)
• Female
• Humans
• Lidocaine (administration & dosage)
• Middle Aged
• Ointments
• Pain Measurement (drug effects)
• Patient Satisfaction
• Probability
• Prospective Studies
• Severity of Illness Index
• Treatment Outcome
• Vulvitis (complications, diagnosis, drug therapy)