Vulvodynia: a neuroinflammatory pain syndrome originating in pelvic visceral nerve plexuses due to mechanical factors

Jacob Bornstein, Eilam Palzur, Michael Swash, Peter Petros

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

This short opinion aimed to present the evidence to support our hypothesis that vulvodynia is a neuroinflammatory pain syndrome originating in the pelvic visceral nerve plexuses caused by the failure of weakened uterosacral ligaments (USLs) to support the pelvic visceral nerve plexuses, i.e., T11–L2 sympathetic and S2–4 parasympathetic plexuses. These are supported by the USLs, 2 cm from their insertion to the cervix. They innervate the pelvic organs, glands, and muscles. If the USLs are weak or lax, gravitational force or even the muscles may distort and stimulate the unsupported plexuses. Inappropriate afferent signals could then be interpreted as originating from an end-organ site. Activation of sensory visceral nerves causes a neuro-inflammatory response in the affected tissues, leading to neuroproliferation of small peripheral sensory nerve fibers, which may cause hyperalgesia and allodynia in the territory of the damaged innervation. Repair of the primary abnormality of USL laxity, responsible for mechanical stimulation of the pelvic sensory plexus, may lead to resolution of the pain syndrome.

Original languageEnglish
Pages (from-to)1411-1415
Number of pages5
JournalArchives of Gynecology and Obstetrics
Volume306
Issue number5
DOIs
StatePublished - Nov 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Funding

FundersFunder number
Centre for Muslim States and Societies, School of Social and Cultural Studies, University of Western Australia
Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia
University of Western Australia
Faculty of Health and Medical Sciences, University of Western Australia
Centre for Muslim States and Societies, University of Western Australia
School of Agriculture and Environment, University of Western Australia

    Keywords

    • Neuroproliferation
    • Provoked vulvodynia
    • Uterosacral ligaments

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