Open access
Peer reviewed journal

Actual Gynecology
and Obstetrics


Extracorporeal Shock Wave Therapy for the Treatment of Vulvodynia. Feasibility Study.
Karel Hurt, Olga Švestková, Michael Halaška, Daniel Driák, Ivana Rakovičová, Martin Musálek, Aneta Krajcová
Actual Gyn 2019, 11, 18-22
Publication date: 2019-03-19
Manuscript ID: 1119002
Počet zobrazení: 17015

Introduction: There are no sufficient therapy strategies for vulvodynia in women. Extracorporeal shock wave therapy (ESWT) is widely used for the treatment of musculoskeletal diseases, muscle spasticity, hypertonus, renal and biliary calculi, urological and recently andrological disorders. We examined the effect of ESWT on vulvodynia in women.  
Methods: A prospective study was conducted between 2015 and 2018 years. The feasibility study involved thirty women with vulvodynia for at least 3 months. The patients received perineally applied ESWT treatment weekly (3 000 pulses each for 4 consecutive weeks). The device used was a standard electromagnetic shock wave unit with a focused shock wave handpiece. The access area was changed after every 500 pulses. Six areas covered the whole vulva and perineum. The grade of pain was evaluated with the visual analogue scale of 11 degrees (VAS, 0-10) before and after the treatment and Cotton Swab test (CST, Goetsch scale 0-4) at the same terms. Follow-ups were done after 1, 4, and 12 weeks having finished the last ESWT. Ethical committee agreement and written consents were provided. 
Results: 29 women completed the study. In VAS and CST testing we proved significant differences between before and all the follow-ups (P < 0.001; P < 0.05) respectively. The reduction of pain in VAS was 53 %; CST 47 % in the last testing. 
Conclusions: ESWT seems to reduce significantly the pain perception in our group of treated patients.  We are encouraged to explore this technique further. The method is easily repeatable, inexpensive, and free of any side effects.

Key words: vulvodynia, chronic pelvic pain syndrome, CPPS, extracorporeal shock wave therapy, ESWT