If you have persistent vulvar pain that hasn’t responded to treatment and is severe and interfering with your enjoyment of life, you may be a candidate for surgery.
Surgery is usually only available if you have a condition called vestibulodynia or provoked vulvodynia (formerly known as vulvar vestibulitis).
Vestibulodynia was first described in 1988 by an American gynaecologist named Edward Freidrich after he had observed a number of women who had severe pain and burning of the vestibule of the vagina.
The vestibule is the external area of skin where the vulva meets the vagina. It was originally thought that this area was inflamed, hence the term "itis". The medical profession later changed the name of the disorder because they now think that the problem originates from changes in nerve fibers rather than inflammation.
• Pain when touched, even if lightly
• Pain when trying to insert tampons (some women can’t)
• Pain when attempting intercourse
• Pain after intercourse
• Pain when wearing tight clothing or when sitting on hard chairs
• Sore genital skin
The pain is often described as a burning sensation in the vulva. Vestibulodynia differs from vulvodynia because it only occurs when the area is touched and is localized to the vestibule.
Vulvodynia is constant pain with no trigger, sometimes in multiple areas of the genitals (for instance, the labia and clitoris may hurt too).
When the pain is localized in vestibulodynia, an operation may be possible to remove the affected area of skin. This is called a vestibulectomy.
The skin at the vestibule is removed. It depends how severe your symptoms are as to how much the surgeon will remove. In moderate cases, only a small amount of tissue is removed.
In more extreme cases, radical surgery can be done to remove much of the external genitalia (the labia and skin near the anus). You will then be given dissolvable stitches to cover over where the skin was removed.
The procedure is done with a general anaesthetic.