Surgical and behavioral treatments for vestibulodynia - Two-and-one-half-year follow-up and predictors of outcome

被引:118
作者
Bergeron, Sophie
Khalife, Samir
Glazer, Howard I.
Binik, Yitzchak M.
机构
[1] Univ Quebec, Dept Sexol, Montreal, PQ H3C 3P8, Canada
[2] McGill Univ, Dept Psychol, Royal Victoria Hosp, Ctr Hlth, Montreal, PQ, Canada
[3] McGill Univ, Jewish Gen Hosp, Dept Obstet & Gynecol, Montreal, PQ H3T 1E2, Canada
[4] Cornell Univ, Weill Coll Med, Dept Obstet & Gynecol, New York, NY USA
[5] Cornell Univ, Weill Coll Med, Dept Psychiat, New York, NY USA
[6] New York Presbyterian Hosp, New York, NY USA
关键词
D O I
10.1097/01.AOG.0000295864.76032.a7
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
OBJECTIVE: To estimate whether treatment gains for provoked vestibulodynia participants randomly assigned to vestibulectomy, biofeedback, and cognitive-behavioral therapy in a previous study would be maintained from the last assessment-a 6-month follow-up-to the present 2.5-year follow-up. Although all three treatments yielded significant improvements at 6-month follow-up, vestibulectomy resulted in approximately twice the pain reduction as compared with the two other treatments. A second goal of the present study was to identify predictors of outcome. METHODS: In a university hospital, 51 of the 78 women from the original study were reassessed 2.5 years after the end of their treatment. They completed 1) a gynecologic examination involving the cotton-swab test, 2) a structured interview, and 3) validated pain and sexual functioning measures. RESULTS: Results from the multivariate analysis of variance conducted on the pain measures showed a significant time main effect (P<.05) and a significant treatment main effect (P<.01), indicating that participants had less pain at the 2.5-year follow-up than at the previous 6-month follow-up. Results from the multivariate analysis of variance conducted on sexual functioning measures showed that participants remained unchanged between the 6-month and 2.5-year follow-up and that there were no group differences. Higher pretreatment pain intensity predicted poorer outcomes at the 2.5-year follow-up for vestibulectomy (P<.01), biofeedback (P<.05), and cognitive-behavioral therapy (P<.01). Erotophobia also predicted a poorer outcome for vestibulectomy (P<.001). CONCLUSION: Treatment gains were maintained at the 2.5-year follow-up. Outcome was predicted by pretreatment pain and psychosexual factors.
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收藏
页码:159 / 166
页数:8
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