POLYMERASE CHAIN-REACTION SEARCH FOR VIRAL ETIOLOGY OF VULVAR VESTIBULITIS SYNDROME

OBJECTIVE: Our purpose was to assess the prevalence of infections by h uman papillomavirus, herpes simplex virus, and cytomegalovirus among w omen with severe vulvar vestibulitis. STUDY DESIGN: Eighty-six women r eferred for dyspareunia and diagnosed as having severe vestibulitis un derwent perineoplasty, including surgical removal of the sensitive ves tibule. Controls included 25 age-matched patients without dyspareunia undergoing vaginal operations for various benign causes or undergoing repair of an episiotomy. Polymerase chain reaction analysis was carrie d out to determine the presence of viral genes. RESULTS: The prevalenc e of herpes simplex virus and cytomegalovirus among the subjects teste d was nit, whereas human papillomavirus was detected in 46 cases (54%) . The human papillomavirus present was not of types 6, 11, 16, 18, or 33. Only one woman of the 25 asymptomatic controls (4%) had human papi llomavirus deoxyribonucleic acid in the vestibule (p < 0.001). CONCLUS ION: Our data provide support for the idea that vulvar vestibulitis is associated with human papillomavirus deoxyribonucleic acid in more th an half of cases.