URETHRAL PRESSURE VARIATION IN WOMEN WITH VULVAR VESTIBULITIS SYNDROME

OBJECTIVES: It is hypothesized that patients with vulvar vestibulitis syndrome will demonstrate increased urethral pressure variability. STU DY DESIGN: Twelve patients with confirmed vulvar vestibulitis syndrome were compared with two groups: 13 patients with chronic pelvic pain m atched for age and race and 23 asymptomatic unmatched patients. Urodyn amic variables studied included maximum urethral pressure, functional urethral length, bladder capacity, and urethral pressure variability. During urethral pressure measurement each patient was given a standard mental exercise. RESULTS: Urethral pressure variability was significa ntly greater in patients with vulvar vestibulitis than in those with c hronic pain or in asymptomatic controls (Wilcoxon test, p < 0.001). Us e of a multiple regression model that controlled for age, race, and pa rity showed that diagnostic group predicted a significant degree of ur ethral pressure variability (F = 8.18, p < 0.001). CONCLUSIONS: Vulvar vestibulitis syndrome is associated with increased urethral pressure variability, and variation in muscular tone of the urethra is the prob able source of this variability. However, the possible relationship wi th the pathogenesis of vulvar vestibulitis syndrome is unknown at pres ent.