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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Womens+Health+(Larchmt) 2016 ; 25 (3): 276-83 Nephropedia Template TP
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Remission, Relapse, and Persistence of Vulvodynia: A Longitudinal Population-Based Study #MMPMID26752153
Reed BD; Harlow SD; Plegue MA; Sen A
J Womens Health (Larchmt) 2016[Mar]; 25 (3): 276-83 PMID26752153show ga
Background: Vulvodynia has been considered to be a chronic disorder. We sought to estimate the probability of and risk factors for remission, relapse, and persistence among women screening positive for vulvodynia.Methods: Survey-based assessment in a longitudinal population-based study of women (the Woman to Woman Health Study) who screened positive for vulvodynia and completed at least four follow-up surveys. Outcome measures included remission without relapse, relapse (after remission), and persistence of a positive vulvodynia screen. Multinomial regression was used to assess factors associated with outcomes.Results: Of 441 women screening positive for vulvodynia during the study, 239 completed 4 additional surveys. Of these, 23 (9.6%) had consistently positive vulvodynia screens, 121 (50.6%) remitted without relapse, and 95 (39.7%) relapsed following remission. Overall, factors associated with both relapse and persistence (compared with remission alone) included increased severity of pain ever (p?0.001) or after intercourse (p?=?0.03), longer duration of symptoms (p???0.001), and screening positive for fibromyalgia (p?0.001). Factors associated with persistence (but not relapse) included more severe symptoms with intercourse (p?=?0.001) and pain with oral sex (p?=?0.003) or partner touch (p?=?0.04). Factors associated with relapse (but not persistence) included having provoked pain (p?=?0.001) or screening positive for interstitial cystitis (p?=?0.05) at first positive vulvodynia screen. Demographic characteristics, age at pain onset, and whether vulvodynia was primary or secondary did not predict outcome.Conclusion: Remission of vulvodynia symptoms is common with approximately half of remitters experiencing a relapse within 6?30 months. Persistence without remission is the exception rather than the rule. Pain history and comorbid conditions were associated with the more severe outcomes of relapse and/or persistence compared with those who remitted only. These findings provide further support that vulvodynia is heterogeneous and often occurs in an episodic pattern.