Long‐term follow up of posterior vestibulectomy for treating vulvar vestibulitis

OBJECTIVE: To evaluate the safety and the effectiveness of posterior vestibulectomy in the treatment of vulvar vestibulitis syndrome. DESIGN: A retrospective cohort study. SETTING: University Hospital, tertiary referral center. POPULATION: Seventy women treated by posterior vestibulectomy for severe vulvar vestibulitis syndrome during 1995-2007 at the Department of Obstetrics and Gynecology, University Hospital, Helsinki. METHODS: All operated women were invited to a long-term follow-up study. Patient characteristics, baseline visual analog scale (VAS) for dyspareunia and data from the postoperative period were collected. Of the 70 women, 57 attended the follow-up visit including face-to-face interview, gynecological examination with swab-touch test for vestibular tenderness, current VAS score for dyspareunia and McCoy questionnaire for sexual problems. MAIN OUTCOME MEASURES: Short-term and long-term complication rates, dyspareunia by VAS score, vestibular tenderness, sexual problem index and overall patient satisfaction. RESULTS: Ninety-one per cent were satisfied with the outcome. The VAS for dyspareunia decreased from a median of 9 to 3 (66.7% decrease; p<0.001). Posterior vestibular tenderness was absent in 34 patients (64.2%). Six (8.6%) patients developed postoperative bleeding and 11 (15.7%) mild wound infection. Bartholin's cysts occurred in four (5.7%) patients. CONCLUSIONS: Posterior vestibulectomy is effective and safe in the treatment of severe vulvar vestibulitis syndrome and provides long-term patient satisfaction.