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Vulvodynie

Vulvodynia

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Zusammenfassung

Die Vulvodynie (vulväre Dysästhesie) bezeichnet mehr als 3 Monate bestehende vulväre Schmerzen (Brennen, Stechen, Reizung sowie Wundsein) des äußeren weiblichen Genitales ohne vorliegende dermatologische oder gynäkologische Ursachen („brennende Vulva“). Unter der primären Vulvodynie werden die vulväre Vestibulitis und die essenzielle (dysästhetische) Vulvodynie verstanden. Die vulväre Vestibulitis ist durch Dyspareunie, Allodynie und ein vulväres Erythem gekennzeichnet. Die meisten Patientinnen sind kaukasischer Herkunft, prämenopausal und sexuell aktiv. Die Prävalenz wird mit bis zu 15% angegeben. Es findet sich ein übersteigertes Schmerzempfinden als Ursache oder Folge einer Schädigung des sympathischen Nervensystems von meist brennendem Charakter. Die psychische Beeinträchtigung, die sich bei vielen Patientinnen findet, ist jedoch eher als Folge der chronischen Beschwerden anzusehen. Die essenzielle Vulvodynie beschreibt demgegenüber ein vulväres Brennen, das nicht auf das Vestibulum beschränkt ist. Die Patientinnen sind hier meist älter, und die Dyspareunie ist weniger schwer ausgeprägt. Die Prävalenz der essenziellen Vulvodynie liegt zwischen 1 und 3%. Verschiedene interdisziplinäre therapeutische Maßnahmen gegen diese beiden relativ häufigen Genitalerkrankungen werden diskutiert.

Abstract

Vulvodynia (vulvar dysesthesia) refers to vulvar pain (burning, irritation and rawness) of the external female genitalia for more than 3 months without other dermatological or gynecological causes. The term primary vulvodynia should be reserved for vulvar vestibulitis and essential (dysesthetic) vulvodynia. Vulvar vestibulitis is characterized by dyspareunia, allodynia and vulvar erythema. Most patients are Caucasian, premenopausal and sexually active. The prevalence is estimated as high as 15%. Damage to the sympathetic nerves with an increased pain sensitivity is the likely explanation for the burning sensation. Psychological impairment, which is common in many patients, rather seems to be the consequence of the chronic disease than a primary condition. Essential vulvodynia is characterized by vulvar burning, which is characteristically not limited to the vestibulum. The patients are generally older and dyspareunia is less severe. The prevalence of essential vulvodynia is 1–3%. Various interdisciplinary approaches to these two rather frequent genital diseases are discussed.

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Authors and Affiliations

  1. Klinik für Dermatologie, Heinrich-Heine-Universität, Düsseldorf

    U. R. Hengge

  2. Klinik für Frauenheilkunde und Geburtshilfe, Universität München

    I. B. Runnebaum

  3. Klinik für Dermatologie, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf

    U. R. Hengge

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  1. U. R. Hengge
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  2. I. B. Runnebaum
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Correspondence to U. R. Hengge.

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Hengge, U.R., Runnebaum, I.B. Vulvodynie. Hautarzt 56, 556–561 (2005). https://doi.org/10.1007/s00105-005-0970-1

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  • DOI: https://doi.org/10.1007/s00105-005-0970-1

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