Vulvodynia is a poorly understood chronic pain condition, and patients who are refractory to standard therapies often pose a therapeutic dilemma. Current treatment modalities include antidepressants, anticonvulsants, biofeedback, pelvic floor physical therapy, and surgery; however, the options are limited for patients who fail to respond to these treatments. We present a case of refractory vulvodynia with severe dyspareunia successfully managed with a novel therapeutic approach combining botulinum toxin A and surgery.
Perspective: The authors present a case of refractory vulvodynia that was successfully managed with a novel approach that combined botulinum toxin A and surgery.
Copyright 2004 American Pain Society