A randomized comparison of group cognitive-behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis

This study compared group cognitive-behavioral therapy (12-week trial), sur face electromyographic biofeedback (12-week trial), and vestibulectomy in t he treatment of dyspareunia resulting from vulvar vestibulitis. Subjects we re 78 women randomly assigned to one of three treatment conditions and asse ssed at pretreatment, posttreatment and 6-month follow-up via gynecological examinations, structured interviews and standard questionnaires pertaining to pain (Pain Rating Index and Sensory scale of the McGill Pain Questionna ire, vestibular pain index, pain during intercourse), sexual function (Sexu al History Form, frequency of intercourse, Information subscale of the Dero gatis Sexual Functioning Inventory), and psychological adjustment (Brief Sy mptom Inventory). As compared with pretreatment, study completers of all tr eatment groups reported statistically significant reductions on pain measur es at posttreatment and 6-month follow-up, although the vestibulectomy grou p was significantly more successful than the two other groups. However. the apparent superiority of vestibulectomy needs to be interpreted with cautio n since seven women who had been assigned to this condition did not go ahea d with the intervention. All three groups significantly improved on measure s of psychological adjustment and sexual function from pretreatment to h-mo nth follow-up. Intent-to-treat analysis supported the general pattern of re sults of analysis by-treatment-received. Findings suggest that women with d yspareunia can benefit from both medical and behavioral interventions. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.