Neuroproliferative processes in vulvodynia

Several studies have documented hyperinnervation and nerve sprouting in the stroma of the vestibule of women with vestibulodynia. Women with primary vestibulodynia-those whose vestibulodynia started with their first attempt at intercourse or physical contact to the vestibule-have been shown to have a higher degree of neuroproliferation than those with secondary vestibulodynia. The findings of hyperinnervation in women with vestibulodynia prompted a search for agents that could be enhancers of nerve growth. One of the potential causative candidates appears to be mast cells. Several animal models of vestibulodynia have been developed to study the steps in the development of vulvodynia. In the 2015 vulvodynia consensus definition, hyperinnervation or "neuroproliferation" is regarded as one of several factors associated with vulvodynia, but it seems logical that this is the actual cause of the allodynia of vestibulodynia.