Surgical treatment for provoked vulvodynia – Where do we stand? A narrative review

Joana Lyra, Joana Lima-Silva, Pedro Vieira-Baptista, Mario Preti, Jacob Bornstein

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


The treatment of vulvodynia remains challenging. Surgery (vestibulectomy) is an option for localized vulvodynia, but it is often considered only after failure of conservative approaches. The authors reviewed the available literature to establish the role, indications, complications, and success rates of surgical procedures. We conducted a literature search of all the papers published and indexed in PubMed since 2011 on the surgical treatment of vulvodynia. Women with localized provoked vulvodynia (LPV) form are the best candidates for the surgical treatment of vulvodynia. Success is associated with secondary LPV, improvement with lidocaine, premenopausal status, and intermittent rather than constant pain. While medical/ conservative treatment should generally be the first option, if a neuroproliferative etiology is suspected, surgery can be a first-line treatment. The available data do not allow us to draw conclusions about the best surgical technique. Efficacy (defined in different ways) is high (52%– 97%). The complication rate is low, cosmetic results are good, and vaginal delivery seems possible. Vestibulectomy is a safe and effective treatment for vulvodynia when delivered to appropriately selected women.

Original languageEnglish
Pages (from-to)120-127
Number of pages8
Issue number3
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 by the International Society for Pelviperineology / Pelviperineology published by Galenos Publishing House.


  • Neuroproliferation
  • Provoked vulvodynia
  • Surgery
  • Vestibulectomy


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