Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis.

Zolnoun DA, Hartmann KE, Steege JF
Obstet Gynecol. 2003 102 (1): 84-7

PMID: 12850611 · DOI:10.1016/s0029-7844(03)00368-5

OBJECTIVE - To assess the effectiveness of nightly application of 5% lidocaine ointment for treatment of vulvar vestibulitis.

METHODS - Over 17 months, we assessed women presenting to our pain clinic for evaluation of introital pain; 61 women met the criteria for vulvar vestibulitis and participated in a treatment trial. We measured daily pain and intercourse-related pain using a 100-mm visual analog scale. We compared ability to have intercourse and pain ratings before and after treatment, and investigated whether prior treatment or gynecologic comorbidities predicted response to treatment.

RESULTS - After a mean of 7 weeks of nightly treatment, 76% of women reported ability to have intercourse, compared with 36% before treatment (P =.002). Intercourse-related pain score was 39.11 (95% confidence interval [CI] 30.39, 47.83) points lower after treatment (P <.001), with a decrease of 10.37 (95% CI 3.53, 17.21) points in daily pain score (P =.004). We found no association between response to prior episodic use of lidocaine and response to nightly therapy with lidocaine ointment. Few patient characteristics predicted response to treatment; however, women with interstitial cystitis and other vulvar conditions were least likely to benefit.

CONCLUSION - Long-term, nightly application of 5% lidocaine ointment shows promise as a treatment for management of vulvar vestibulitis; a randomized, double-blind, clinical trial is warranted.

MeSH Terms (18)

Administration, Topical Adult Cohort Studies Confidence Intervals Drug Administration Schedule Dyspareunia Female Humans Lidocaine Middle Aged Ointments Pain Measurement Patient Satisfaction Probability Prospective Studies Severity of Illness Index Treatment Outcome Vulvitis

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