{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:20:10Z","timestamp":1787984410346,"version":"build-2784847793"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,1,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The current approach to women with provoked vestibulodynia (PVD) comprises a multidimensional, multidisciplinary therapeutic protocol. As PVD is considered to be a chronic pain disorder, transcutaneous electrical nerve stimulation (TENS) can be used as an additional therapy for women with otherwise therapy-resistant PVD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The aims of this study were to evaluate whether TENS has a beneficial effect on vulvar pain, sexual functioning, and sexually-related personal distress in women with therapy-resistant PVD and to assess the effect of TENS on the need for vestibulectomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A longitudinal prospective follow-up study was performed on women with therapy-resistant PVD who received additional domiciliary TENS. Self-report questionnaires and visual analog scales (VASs) were completed at baseline (T1), post-TENS (T2), and follow-up (T3).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Vulvar pain, sexual functioning, and sexually-related personal distress were the main outcome measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-nine women with therapy-resistant PVD were included. Mean age was 27\u2009\u00b1\u20095.6\u2009years (range: 19 to 41); mean duration between TENS and T3 follow-up was 10.1\u2009\u00b1\u200910.7\u2009months (range: 2 to 32). Vulvar pain VAS scores directly post-TENS (median 3.4) and at follow-up (median 3.2) were significantly (P\u2009&amp;lt;\u20090.01) lower than at baseline (median 8.0). Post-TENS, sexual functioning scores on the Female Sexual Functioning Index questionnaire had improved significantly (P\u2009=\u20090.2); these scores remained stable at follow-up. Sexually-related personal distress scores had improved significantly post-TENS (P\u2009=\u20090.01). Only 4% of the women who received TENS needed to undergo vestibulectomy vs. 23% in our previous patient population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The addition of self-administered TENS to multidimensional treatment significantly reduced the level of vulvar pain and the need for vestibulectomy. The long-term effect was stable. These results not only support our hypothesis that TENS constitutes a feasible and beneficial addition to multidimensional treatment for therapy-resistant PVD, but also the notion that PVD can be considered as a chronic pain syndrome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/jsm.12740","type":"journal-article","created":{"date-parts":[[2014,11,12]],"date-time":"2014-11-12T08:10:40Z","timestamp":1415779840000},"page":"228-237","source":"Crossref","is-referenced-by-count":37,"title":["Transcutaneous Electrical Nerve Stimulation as an Additional Treatment for Women Suffering from Therapy-Resistant Provoked Vestibulodynia: A Feasibility Study"],"prefix":"10.1093","volume":"12","author":[{"given":"Marleen S.","family":"Vallinga","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University of Groningen \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University Medical Center Groningen \u00a0 \u00a0 , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Symen K.","family":"Spoelstra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University of Groningen \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University Medical Center Groningen \u00a0 \u00a0 , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge L.M.","family":"Hemel","sequence":"additional","affiliation":[{"name":"Private floor physiotherapy practice Pelvicum , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry B.M.","family":"van de Wiel","sequence":"additional","affiliation":[{"name":"Wenckebach Institute \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University of Groningen \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University Medical Center Groningen \u00a0 \u00a0 , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willibrord C.M.","family":"Weijmar Schultz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University of Groningen \u00a0 \u00a0 , Groningen , The Netherlands"},{"name":"University Medical Center Groningen \u00a0 \u00a0 , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,1,1]]},"reference":[{"key":"2023010704084190300_bb0010","first-page":"772","article-title":"2003 ISSVD terminology and classification of vulvodynia: A historical perspective","volume":"49","author":"Moyal-Barracco","year":"2004","journal-title":"J Reprod Med"},{"key":"2023010704084190300_bb0015","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.3109\/00016349.2010.528368","article-title":"Medical and physical predictors of localized provoked vulvodynia","volume":"89","author":"Bohm-Starke","year":"2010","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2023010704084190300_bb0020","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1743-6109.2005.20347.x","article-title":"Women\u2019s sexual pain and its management","volume":"2","author":"Weijmar Schultz","year":"2005","journal-title":"J Sex Med"},{"key":"2023010704084190300_bb0025","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/00005053-199709000-00005","article-title":"Dyspareunia: Sexual dysfunction or pain syndrome?","volume":"185","author":"Meana","year":"1997","journal-title":"J Nerv Ment Dis"},{"key":"2023010704084190300_bb0030","first-page":"82","article-title":"A population-based assessment of chronic unexplained vulvar pain: Have we underestimated the prevalence of vulvodynia?","volume":"58","author":"Harlow","year":"2003","journal-title":"J Am Med Womens Assoc"},{"key":"2023010704084190300_bb0035","first-page":"110","article-title":"Vulvar vestibulitis syndrome","volume":"32","author":"Friedrich","year":"1987","journal-title":"J Reprod Med"},{"key":"2023010704084190300_bb0040","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0304-3959(00)00449-8","article-title":"A randomized comparison of group cognitive\u2014Behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis","volume":"91","author":"Bergeron","year":"2001","journal-title":"Pain"},{"key":"2023010704084190300_bb0045","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/0002-9378(86)90472-2","article-title":"Focal vulvitis: A characteristic syndrome and cause of dyspareunia. 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