Transcutaneous Electrical Nerve Stimulation as an Additional Treatment for Women Suffering from Therapy‐Resistant Provoked Vestibulodynia: A Feasibility Study

IntroductionThe current approach to women with provoked vestibulodynia (PVD) comprises a multidimensional, multidisciplinary therapeutic protocol. As PVD is considered to be a chronic pain disorder, transcutaneous electrical nerve stimulation (TENS) can be used as an additional therapy for women with otherwise therapy‐resistant PVD.AimsThe aims of this study were to evaluate whether TENS has a beneficial effect on vulvar pain, sexual functioning, and sexually‐related personal distress in women with therapy‐resistant PVD and to assess the effect of TENS on the need for vestibulectomy.MethodsA longitudinal prospective follow‐up study was performed on women with therapy‐resistant PVD who received additional domiciliary TENS. Self‐report questionnaires and visual analog scales (VASs) were completed at baseline (T1), post‐TENS (T2), and follow‐up (T3).Main Outcome MeasuresVulvar pain, sexual functioning, and sexually‐related personal distress were the main outcome measures.ResultsThirty‐nine women with therapy‐resistant PVD were included. Mean age was 27 ± 5.6 years (range: 19 to 41); mean duration between TENS and T3 follow‐up was 10.1 ± 10.7 months (range: 2 to 32). Vulvar pain VAS scores directly post‐TENS (median 3.4) and at follow‐up (median 3.2) were significantly (P < 0.01) lower than at baseline (median 8.0). Post‐TENS, sexual functioning scores on the Female Sexual Functioning Index questionnaire had improved significantly (P = 0.2); these scores remained stable at follow‐up. Sexually‐related personal distress scores had improved significantly post‐TENS (P = 0.01). Only 4% of the women who received TENS needed to undergo vestibulectomy vs. 23% in our previous patient population.ConclusionThe addition of self‐administered TENS to multidimensional treatment significantly reduced the level of vulvar pain and the need for vestibulectomy. The long‐term effect was stable. These results not only support our hypothesis that TENS constitutes a feasible and beneficial addition to multidimensional treatment for therapy‐resistant PVD, but also the notion that PVD can be considered as a chronic pain syndrome. Vallinga MS, Spoelstra SK, Hemel ILM, van de Wiel HBM, and Weijmar Schultz WCM. Transcutaneous electrical nerve stimulation as an additional treatment for women suffering from therapy‐resistant provoked vestibulodynia: A feasibility study. J Sex Med 2015;12:228–237.