{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:35:05Z","timestamp":1762101305058},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,7,2]],"date-time":"2012-07-02T00:00:00Z","timestamp":1341187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> To compare long\u2010term well\u2010being of women who needed surgery or did not need surgery in the treatment of severe vulvar vestibulitis syndrome. We also attempted to identify factors explaining differences in the treatment response. <jats:italic>Design.<\/jats:italic> An observational case\u2010control study. <jats:italic>Setting.<\/jats:italic> University Hospital Vulva clinic. <jats:italic>Population.<\/jats:italic> Sixty\u2010six women diagnosed with severe vulvar vestibulitis and treated initially by conservative management during 1994\u20132005. Thirty\u2010nine women did not respond and underwent posterior vestibulectomy and 27 were managed without surgery. <jats:italic>Methods.<\/jats:italic> Baseline patient characteristics, degree of dyspareunia, and details of management were collected from hospital charts. At the follow\u2010up visit current dyspareunia, sexual well\u2010being, somatic and mental health, and social support were analyzed. Vestibular tenderness was measured by swab\u2010touch test. <jats:italic>Main outcome measures.<\/jats:italic> Visual analogue scale for dyspareunia, sexual well\u2010being, vestibular tenderness<jats:bold>,<\/jats:bold> and overall patient satisfaction at follow\u2010up. <jats:italic>Results.<\/jats:italic> Dyspareunia decreased significantly in both groups. The visual analogue scale decreased 66.7% in the surgery group and 78.1% in the conservative treatment group (<jats:italic>p<\/jats:italic>= 0.407). Posterior swab\u2010touch test was negative more frequently after vestibulectomy. Long\u2010term sexual well\u2010being did not differ between the two groups. Overall, 89% of the women in both groups were satisfied with the treatment. Women with atopic skin problems were less likely to need surgery (odds ratio 0.2; 95% confidence interval 0.1\u20130.7). <jats:italic>Conclusion.<\/jats:italic> Women with severe vulvar vestibulitis syndrome who do not respond to conservative management achieve good long\u2010term well\u2010being and decrease of dyspareunia by posterior vestibulectomy. The response is comparable to that achieved by conservative management among women who do not need surgery.<\/jats:p>","DOI":"10.1111\/j.1600-0412.2012.01466.x","type":"journal-article","created":{"date-parts":[[2012,5,23]],"date-time":"2012-05-23T16:18:00Z","timestamp":1337789880000},"page":"1086-1093","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Long\u2010term well\u2010being after surgical or conservative treatment of severe vulvar vestibulitis"],"prefix":"10.1111","volume":"91","author":[{"given":"P\u00c4IVI","family":"TOMMOLA","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LEILA","family":"UNKILA\u2010KALLIO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JORMA","family":"PAAVONEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,7,2]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199709000-00005"},{"key":"e_1_2_9_3_2","first-page":"82","article-title":"A population\u2010based assessment of chronic unexplained vulvar pain: Have we underestimated the prevalence of vulvodynia?","volume":"58","author":"Harlow BL","year":"2003","journal-title":"J Am Med Womens Assoc."},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200307000-00017"},{"key":"e_1_2_9_5_2","first-page":"713","article-title":"Treatment of vulvar vestibulitis with submucous infiltrations of methylprednisolone and lidocaine. 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