PERINEOPLASTY COMPARED WITH VESTIBULOPLASTY FOR SEVERE VULVAR VESTIBULITIS

Objective To evaluate the efficacy of vestibuloplasty (vestibular unde rcutting without excision) to treat severe vulvar vestibulitis. Design Prospective randomisation of patients scheduled for surgery to underg o either perineoplasty or vestibuloplasty. Differences in outcome betw een groups were analysed using Fisher's exact test. Setting The Vulvar Clinic and referral centre for vestibulitis, Kupath Holim Health Syst em, Department of Obstetrics and Gynaecology, Carmel Medical Centre, R apapport Faculty of Medicine, Hatechnion, Haifa, Israel. Subjects Twen ty-one women with vulvar vestibulitis. Results Vestibuloplasty failed to relieve symptoms in 10 women, while perineoplasty resulted in compl ete resolution of symptoms in 9/11 women (P < 0.002). Conclusions The poor outcome of vestibuloplasty, if also reported by other centres, ma y render it an unacceptable treatment for vulvar vestibulitis. Vestibu loplasty aims to denervate sensitive vestibular tissue, and its failur e may suggest that innervation disturbances are not the main cause of the syndrome.