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Re: VulvodyniaFrom: Joanne Bulley, MD (islesannie@gmail.com)Mon Feb 19 18:07:59 2007
1. high potency steroid such as clobetasol (Temovate) 2. neurologic meds such as a tricyclic (amitriptyline) or neruontin/gabapentin 3. PT with someone who has very good experience with pelvic floor biofeedback therapy Sometimes these patients were abused (possibly with no recollection) and there is significant pelvic floor or urogenital diaphragm muscle spasm contributing toe the vestibulodynia. Full work up of the spine for anatomic impingement on the pudendal nerves. Vesibulectomy only if all other possibilities have been exhausted. This includes consults with experts in the field such as Elizabeth Stewart (Boston) Hope Haefner (Ann ARbor, Mich) or Lynetter Margesson (Manchester, NH) http://www.med.umich.edu/obgyn/vulva/links.htm Joanne
At Mon, 19 Feb 2007, Efrain Ramirez wrote:
>
-- Joanne Bulley, MD, FACOG Solo gyn Keene, NH USA
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