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Long Term Effectiveness of Capsaicin for the Treatment of Vulvar Vestibulitis

Long Term Effectiveness of Capsaicin for the Treatment of Vulvar Vestibulitis

To demonstrate long term efficacy of capsaicin cream for patients with vulvar vestibulitis. Materials and Methods: A retrospective chart review was performed in September 2005 evaluating 52 patients from an original capsaicin treatment group in 2003. In the 2003 study, patients with vulvar vestibulitis (VV) applied capsaicin cream 20 minutes daily for twelve weeks. Diagnosis of Vulvar Vestibulitis was made via Kaufman touch test at five vulvar locations. 

At study completion, 95% subjects resumed intercourse, demonstrating statistically significant improvement in Kaufman and Marinoff scores. Subsequently, subjects were instructed to use capsaicin on an “as needed” basis. In this 2005 study, chart review evaluated long term progress of the original study cohort. Comparisons were made between initial Marinoff and Kaufman scores and those from the last clinical visit in 2005.

The cohort comprised 45/52 (87%) of initial patients. The mean age was 33.8 (21-64) years. The length of time since initial use of capsaicin was 37.2 (+/-12.0) months. A Student T test compared pre-treatment and long term follow-up values. The mean sum of the pretreatment 13.2 (+/-4.9) Kaufman touch test compared with the last visit 3.9 (+/-4.5) was statistically significant (P< .0001). Marinoff dyspareunia scales also demonstrated significant improvement (P< .0001).

Significant change was observed at individual touch test sites (P< .0001). 26 of 45 subjects (58%) used “as needed” capsaicin 0-3x per week (mean =1 x/ week) for a period of 14.6 (+/-11.1) months, requiring no additional therapy. 19 of 45 subjects (42%) required adjuvant pelvic floor muscle triggerpoint injections. A significantly greater number in this group had the diagnosis of Interstitial Cystitis 6/19 (IC = 31.5%) compared to the no additional therapy group 2/26 (IC =7.7%).

Capsaicin has long term effectiveness in decreasing discomfort and allowing for more frequent sexual relations in patients with vulvar vestibulitis.

Conference: Demo