LIDOCAINE OVERNIGHT FOR V V

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ORIGINAL RESEARCH Overnight 5% Lidocaine Ointment for Treatment of Vulvar Vestibulitis Denniz A. Zolnoun, MD, MPH, E. Hartmann, MD, PhD and F. Steege, MD From the Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. Address reprint requests to: Denniz Zolnoun, MD, MPH, CB#7570, University of North Carolina, School of Medicine, Chapel Hill, NC 27599-7570; E-mail: denniz_zolnoun (AT) med (DOT) unc.edu . 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.

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has this worked for anyone? I tried it about 2 years ago, and unfortunately

had not long-term success whatsoever. It helped me on a nightly basis, but

that was it. And it actually gave me some freaky skin sloughing. (I've

realized that if there is a side effect to something, I will have it :-)

nicole

>

>Reply-To: VulvarDisorders

>To: VulvarDisorders

>Subject: LIDOCAINE OVERNIGHT FOR V V

>Date: Fri, 17 Aug 2007 19:27:17 -0700 (PDT)

>

>

>

> ORIGINAL RESEARCH Overnight 5% Lidocaine Ointment for Treatment of

>Vulvar Vestibulitis Denniz A. Zolnoun, MD, MPH, E. Hartmann,

>MD, PhD and F. Steege, MD

>

> From the Department of Obstetrics and Gynecology, University of North

>Carolina School of Medicine, Chapel Hill, North Carolina. Address reprint

>requests to: Denniz Zolnoun, MD, MPH, CB#7570, University of North

>Carolina, School of Medicine, Chapel Hill, NC 27599-7570; E-mail:

>denniz_zolnoun (AT) med (DOT) unc.edu denniz_zolnoun (AT) med (DOT) unc.edu'//--> .

>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.

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