Vulvar Vestibulitis

Vulvar Vestibulitis is characterized by pain limited to the vestibule, the area surrounding the opening of the vagina. The pain of Vulvar Vestibulitis is present when pressure is applied to the vestibule (sexual intercourse, tampon insertion, prolonged sitting) and is described as burning, soreness, stinging, rawness, throbbing, or itching. Causes include:

• Chronic irritation to the vestibule from irritants such as creams, moisture, soap, etc.
• Recurrent yeast infections
• Genetic susceptibility to vulvar irritation and vulvar pain

The mainstay of treatment and future prevention is the avoidance of irritants to the vulva. This includes the discontinuation of topical creams and irritant soaps. It is also important to rinse the opening of the vagina thoroughly with water at the end of a shower (to remove any soap residue). Drying the vestibule after the shower and then making an effort to keep the vestibule dry and open to air during the day and night is essential.

Treatment may also include steroid injection of the vestibule. Refractory cases are treated by Vulvar Vestibulectomy.

At Austin Urogynecology, we see over 50 patients a year for Vestibulitis. Approximately 80% of patients referred are successfully treated with hygiene changes/steroid injections while approximately 20% of patients referred require Vestibulectomy.