answers to questions about injections

[Guest guest]

Hi everybody,

At the end of this message, I have pasted the abstract

from the article that outlines the protocol for the

injections I received to treat my vulvodynia and

vulvar vestibulitis. If you are interested in this

treatment, get a copy of the article and show it to

your doctor. That's what I did, and my doc was willing

to give it a try. The article is in the August 2001

Journal of Reproductive Medicine, volume 46, pages

713-716.

> , was it

> uncomfortable?

> I can't imagine that it would be worse then when I

> had injections for my biopsies.

The injections were painful, but the discomfort went

away in about 30 seconds when the lidocaine kicked in.

I had injections at three different visits. After the

first visit, I had an increase in vulvar burning

after the lidocaine wore off. The increase in burning

lasted the rest of the day. It was pretty

uncomfortable, but I took Lortab every four hours,

which made the pain go away. There was *no* increase

in vulvar burning after the second and third visits.

> Also did you have

> any

> problems with bladder control afterwards?

No.

> I hate to ask but what is dyspareunia?

Pain with intercourse. After seven years, I had

honestly forgotten what it was like to not experience

pain during sex.

> What did they

> inject you with and can

> you get the protocol for us?

The injections were methylprednisolone (steroid) and

lidocaine (local pain reliever). To get the protocol,

you must get a copy of the article. You can either go

to a library and copy the article, or order a copy

through a library. I was able to order a copy through

my school. I'm not sure how to get a copy if you are

not a student or near a library. Ideas, anyone?

Abstract (summary) of the article:

Treatment of vulvar vestibulitis with submucous

infiltrations of methylprednisolone and lidocaine. An

alternative approach.

Murina F, Tassan P, i P, Bianco V.

Outpatient Department of Vulvar Disease, Center for

the Early Diagnosis of Female Genital Cancer, Via

Faravelli n. 31, Milan, Italy. murina@...

OBJECTIVE: To assess the efficacy of submucous

infiltrations of methylprednisolone and lidocaine into

the vulvar vestibule for the treatment of vulvar

vestibulitis. STUDY DESIGN: Twenty-two patients were

referred for vulvar vestibulitis. Methylprednisolone

and lidocaine were injected into the vulvar vestibule

once a week for three weeks at decreasing doses (1,

0.5, 0.3 mL). Follow-up was performed monthly for

three months, then at six and nine months. Fourteen

women have had 12 months and 5 women, 24 months of

follow-up. RESULTS: Fifteen women (68%) responded

favorably to the treatment, seven (32%) with absence

of symptoms and eight (36%) with a marked improvement.

Seven patients (32%) failed to respond in spite of a

fourth dose (0.3 mL) given after 30 days. No relapse

was observed at nine months' follow-up, while a

further 0.5 mL infiltration followed by quick

remission of symptoms was needed after one year in

five patients. Five patients completed the 24 months'

follow-up, with no need for further treatment.

CONCLUSION: Submucous infiltration allows

methylprednisolone to be deposited in the submucosa,

the site of the inflammatory reaction, while the depot

formulation allows gradual and prolonged release of

the drug. Seven patients (32%) failed to respond,

suggesting either that they had a kind of vulvar

vestibulitis syndrome where inflammation is less

remarkable or failure of the infiltrated drug to

become adequately diffused.

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