{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T02:20:36Z","timestamp":1772850036451,"version":"3.50.1"},"reference-count":81,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The main objective of this review was to develop strategies for individualizing multidisciplinary therapy for vulvodynia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted two literature searches; the first one focused on clinical trials assessing vulvodynia treatments published after the recommendations of the expert committee of the Fourth International Consultation on Sexual Medicine. The second search targeted studies identifying predictive factors and mediators of vulvodynia treatments, published from the earliest date to October 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on data from 55 relevant studies, we developed models of individualized multidisciplinary therapy targeting groups of women less responsive to multidisciplinary therapy (characterized by women with higher vulvar pain intensity, impaired sexual functioning, and vulvodynia secondary subtype) and to physical therapy, as an isolated treatment (characterized by women with increased pelvic floor muscle tone and vulvodynia primary subtype). Each individualized multidisciplinary therapy model comprises three components: psychotherapy, medical care, and physical therapy. These components provide distinct therapeutic modalities for distinct subgroups of women with vulvodynia; the women subgroups were identified according to the characteristics of women, the disease, partners, and relationships. Additionally, for women with provoked vestibulodynia who exhibit less benefits from vestibulectomy (such as those with higher levels of erotophobia, greater vulvar pain intensity, and the primary subtype) and encounter resistance to individualized multidisciplinary therapy, we suggest additional conservative treatments before performing vestibulectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study is a pioneer in the development of models that allow the individualization of multidisciplinary therapy for vulvodynia and represents a significant advance in the clinical practice of gynecologists, physiotherapists, and psychologists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15829","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T04:39:28Z","timestamp":1700109568000},"page":"147-174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Individualized multidisciplinary therapy for vulvodynia"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0242-3804","authenticated-orcid":false,"given":"Sonia Regina Lenharo","family":"Penteado","sequence":"first","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio Emilio","family":"Bonduki","sequence":"additional","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa Raquel Embiru\u00e7u","family":"de Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzana Valeska","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina Morena Teixeira","family":"de Luccas Batista","sequence":"additional","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Carvalho","family":"Ambrogini","sequence":"additional","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marair Gracio Ferreira","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of Gynecology Federal University of S\u00e3o Paulo\u2014UNIFESP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001359"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.09.033"},{"issue":"2","key":"e_1_2_9_4_1","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_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2015.12.021"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-017-1026-1"},{"issue":"5","key":"e_1_2_9_7_1","first-page":"223","article-title":"The evidence\u2010based vulvodynia assessment project. 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