vrijdag, 01 december 2017 10:04

Abstract NVVS Wetenschapsdag 2017: The relationship between vulvodynia and vulvovaginal candidiasis - a systematic review

  • Geschreven door:
    Suzanne van de Pasch

Background: Provoked vulvodynia is a chronic vulvar pain condition affecting up to 8.3% of the female population. Despite many years of research no clear cause for provoked vulvodynia has been identified. Several risk factors have been studied, including vulvovaginal candidiasis. However, to date, the role of Candida infections in provoked vulvodynia has remained unclear. Vulvovaginal candidiasis and provoked vulvodynia have an overlap of symptoms which may contribute to diagnostic inaccuracy.                                                                                                                                                                                                                                                                                                                    Objective: We aimed to investigate the relationship between vulvovaginal candidiasis and provoked vulvodynia.                                                                                                                                                                                                  Study design: We searched CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, Pubmed and Web of Science for relevant studies published over the last 15 years. Studies were included if they were original research, relevant, and compared women with provoked vulvodynia with healthy controls. The inclusion process as well as quality appraisal, using the Newcastle-Ottawa quality assessment Scale, were performed in duplicate and independently by two authors.                                                                                                                                                                                                                                                                                                                                                                  Results: We included a total number of 6 studies, both epidemiological and pathophysiological research. All included epidemiological studies showed a significantly increased OR for self-reported vulvovaginal candidiasis in provoked vulvodynia cases compared to controls. The included pathophysiological studies revealed a tendency of an increased pro-inflammatory response on Candida in vitro in patients with provoked vulvodynia.                                            Conclusions: Our study showed that self-reported vulvovaginal candidiasis is related to provoked vulvodynia. The suggestion of a causative relationship remains controversial based on currently available studies. Until new evidence becomes available, we advocate that PVD should be regarded as an unexplained chronic pain condition.