role of colposcopy in the diagnosis and management of chronic vulvar pain [vulvodynia]

ABSTRACT

Fifty women complaining of chronic vulvar pain and 22 age-matched patients without pain were selected for this study. After full gynecological examination, a histopathologic analysis was carried out and biopsy was taken from any detected lesion. The results showed that vulvodynia was found to be either primary or secondary; the primary is the commonest and may be diffuse or localized and the secondary may be associated with lower genital infection, rectal and/or urethral lesions. The characteristic colposcopic lesion was the acetowhite area with or without the associated micropapillary lesion detected in 24% of the cases. Cases having such lesion showed epithelial koilocytosis by a histopathological examination and it indicated chronic HPV infection. It was concluded that chronic HPV infection is definitely a cause of vulvodynia. Colposcopy examination is essential in these cases as well as histopathology and bacteriology are essential for the confirmation of the diagnosis and planning the management