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Re: vulval pain From: Braun, R. Daniel (rbraun@iupui.edu) Mon Aug 9 17:08:57 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Braun, R. Daniel: "Re: ovarian cysts" Previous message: Roberta Speyer: "OBGYN.net's Laparoscopy & Hysteroscopy Special Section Update" Maybe in reply to: James Brodribb: "vulval pain" Don't operate. Dan -----Original Message----- From: jkbrod@ozemail.com.au To: Multiple recipients of list OB-GYN-L Sent: 8/8/99 7:13 AM Subject: vulval pain I have a post-menopausal woman with severe vulval pain. Described as like an orgasm but painful.My first contact was in relation to pain in LIF in association with a simple ovarian cyst 6cms diameter-previous TAH. Laparotomy for ? ovarian entrapment revealed the cyst had burrowed retroperitoneally. Removal was uneventful but the pain persisted (benign histology). Closer questioning revealed pain to be vulval in the region of the symphysis. Seen by rheumatologist and lost to me for a year. Came back from another state after 12 months. Had seen O&G who questioned clitoral priapism, an A-V fistula in the cavernosus body or perhaps atypical epilepsy. EEG normal. Angiography revealed attenuated flow in the vulval region so had gelfoam embolisation-to no effect. After 3 months pain eased for a couple of months and now is returning-severely. Vascular surgeon suggested excision of the cavernosus body. Previous depression but no therapy now. Clinically tender over clitoral region and under the inferior pubic rami.Nil else to find. CT previously normal. She looks and sounds depressed but will not see a psychiatrist. ?any suggestions for investigation/treatment Next message: Braun, R. Daniel: "Re: ovarian cysts" Previous message: Roberta Speyer: "OBGYN.net's Laparoscopy & Hysteroscopy Special Section Update" Maybe in reply to: James Brodribb: "vulval pain"

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