FBGVZF
(2006 SZP) 'D 'CGI ,145 LZM
SYKZG\
\ZEB KGRK[C \ZCD F\GB {
(Vulvodynia)
QKKJ[RZGC CYTK ,BPG\ BCGZ FVKI ,QGKRMJF ,JZGVVZ FBGVZN FJNGYVFG FKKZFR ,KCZTPF NKNDN OKNGI-\KC ,F[KBF \GBKZCN UDBF
BN \GRICB OKBVGZF OKTCGY LMP FBXG\M .FN[ \GRG[F \GKGR
Q\KKTC \B QKCFN QRGKSKRC \GNVGJPF NT F[YPF CXP ,\GEKIB
.OKRG[ OKNGVKJ \GBXG\ \BGG[FN TKZVPG ,OKB\P NGVKJ NCYNG
\RGPSK\ N[ IGRKPF \GMGVF\ \GDXGP \KIMGRF FZKYSC
LG\P .OGKM NCGYPF ,KVGSF IGRKPF \TKCY ET FKZTC CBMF
N[ \MNGFG \ZCGDF FRCFF NT EGPNN Q\KR IGRKPC OKKGRK[F .\GRGZIBF OKR[C \RGPSK\N OKPZGDF
FKZTC CBM N[ OKPEYGPF OKZGBK\F \KBGVZF
\GZVKSC
TKVGF
FKZTC
C BM
N[
OKRKPS\F
ZGBK\
Alexander J.C. OKR[ FRGP[ ZGCTM .|2~ 1880 \R[C FRG[BZN \GNIP" NT ZVSC Hyperesthesia of the Vulva ZBK\ Skene
Z\K-\G[KDZC \RKKVGBP \BHF FNIPF" :C\M BGF .|3~ "F[KBF FYKECC OKZIB OKKGJKC GB OEGB BNN ,EZD BNN ,FKZTF N[ \NVGJPF ,[KDZF ZGHBC TDGR YEGCF[ TDZC ,NCB .\KRVGDF QM OD \KRKP \GNKTV .YGTXN FN OZGD OKPTVN[ ,CBM NT \RRGN\P ZBK\
1928
\R[C
."\KZ[VB
K\NC
OK[Y
OKZYPCG
N[ \KZKZC EGBP \G[KDZ \GPGEB \GEGYR" :|4~
,\CBGM
Howard Kelly
\KRKP \GNKTV QPHC CBMN ZGYP \GGFPF QKNG\CF OGZY \TCJ
\GZVKSC BKF
ZMHGB
LMN
BN
FCKSF[
CXPF QM\KK
Kelly
,
.OKZG[T
."( N[
Dyspareunia)
OGSZKVF
F[KPIM
ZIB N
L[PC
\KBGVZF
OKCXPP GPNT\F ,NNMC FZCIFG \KBGVZF FZCIF ,GH FVGY\C[ .F[KBF NXB QKPF KKIN OKZG[YF \GNIPG
FKZTC CBM N[ IGRKPF \GI\V\FC [EIF QEKTF FKZTF \GNIP ZYIN \KPGBNRKCF FZCIF FPYGF 1970 \R[C
International Society for the Study of Vulvovaginal QENFG ISSVD) Disease \GCZ FEKZJF[ FKTCC QGEN ,ISSVD-C FZCI ,Esther Weisfogel F[YKC 1976 \R[C FZCIF N[ KPNGTF SRMC .(
EPTP G\GBC .FKZTF BGCPC FCKZXG CBMP GNCS[ ,FK\GNVGJPP
The burning vulva syndrome" :GH FKTC F\RKM BKF -G Tovell KEK-NT TXGF ,Vulvodynia ,FKTCN ZIB KGRKM FPKTR BN F[GI\G EZD"-M FH CXP GZBK\ OF .|7~ Young .|6,5~ "
OKBXPKP
ZETKFC
\BHG
,UZG[
NNM-LZEC[
CBMC
OKGGNPF
TXGF OKR[F OT .|7~ "\K\MZTP FNIPN OKK\ECTP GB OKKRKNY EZD KM NCGYP OGKMG ,FKZTC CBMP EZD NT FRGN\F \B EKZVFN .FKZTC CBMF \RGPSK\P YNI GRKB N[ F\[YCN FCGD\M ,1983 \R[C FZCIF N[ KTKC[F SRMC IR G PM
215
FKZTC CBMF \RGPSK\
Vulvodynia IRGPF \B SRMF \BKNP FXPKB ,Weisfogel
\KRGZM \GIGR-KB" :LM G\GB FZKEDFG ,FKZTC CBM ZGBK\N KNNM WIN GB WGXYKT OKPTVN) FVKZ[ N[ FRGN\C \RKKVGBPF ,FKZTC BGF
Vulvodynia
IRGPF[ FZCIF FTCY ,FHN USGRC ."(KPGYP
ZKXY\
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nternational Society for the Study
of Vulvovaginal Disease (ISSVD)
Burning vulva syndrome
Vulvodynia
Vulvar Dysesthesia
Dysesthetic
Vulvodynia
vulvodynia
Vestibulitis
Vestibulodynia
Vulvodynia
FPEYF ORPGB .QKP-KSIK OGKY \TC FKZTC CBMP \GNCGS \GCZ OK[ CBM NT \GRRGN\PF OK[R N[ OKZGBK\ BGXPN FKF ZKER
R
,GMNFG GCZ GH FKTC NT \GRGN\F HBP LB ,FR[ 30 KRVN ET FKZTC .B[GRN OK[RF N[ \GTEGPF \KKNT CYT FBZRM KBNKDC OK[RFP 16%-N FTKDP FKZTC CBM N[ CXP \GIKM[ QM-NTG ,FKZTC CBMN OKPZGDF GZGGI\F BN QKKET .|1~ FR[ 64=18 -P\SFNG FKTCN OKB\PF IGRKPF \TKCYC OKIPGPF OKJCI\P -GCKJSG ,SKJKNGCKJSG ,FKZTF \GNIP ,FKZTC CBMF \RGPSK\ :
I\VP \GNKP
.QENFG FKZTF \GNIP ZYIN \KPGBNRKCF FZCIF ,FKRKEGN
Key words: Vulvar diseases; Vulvodynia; Vestibulitis; Vestibulodynia;
International Society for the Study of Vulvovaginal Disease.
FBGVZF
(2006 SZP) 'D 'CGI ,145 LZM
.|10~ "KCXT ZGYPP \ZEDGP BN
Vulvar vestibulitis or Vestibulodynia
Vulvar :N[
IRGPF
\GRP\SF
\B OT
:'C FXGCY-\\
Edward Friedrich TCJ 1987 \R[C OK[R ZB\N KEM Vestibulitis syndrome
FZKEI QGKSKR GB FKZTF ZGHBC FTKDR ZIBN TKVGPF YHI CBM (1 OKBXPKP (3-G ;FKZTF BGCPC OYGPPF WINN \G[KDZ (2 ;QENN F[GN[ .|11~ \GRG[ \GDZEC FKZTC OEGBP OKCMZGPF OKKRVGD
Burning FZCIN IR G PC
.|6,5~ \KRVGDF FYKECC OKBXPKPN IGRKPFP QGXZ-KTC[ GKF FZCIF KZCI NM BN
Peter Lynch TKXF 1985 Burning vulva syndrome
GB
FVKZ[
HB
F[KDZP
WINN FCGD\M YZ OZDR CBMF
Vestibulitis
-[ EGTC ,KRGPXT QVGBC BNG KPGYP TDP GB CBMM
FZEDGF
OYGPP BNN
GRKB[ OZDRFG
Dysesthetic Vulvodynia ,FKZTC ,FKZTF
J[GVP BGCPC
,KRGPXT BYGGE
FNBF OKDGS-\\F KR[ .OKKRVGD OKBXPKP
Vestibulitis EGTC ,Vestibulectomy Dysesthetic Vulvodynia .Amitriptyline-C
QGDM KIG\KR NGVKJC GIKNXK OT
OK[R[
:'D FXGCY-\\ \B GR\XGCYP OKZYGI GTCJ 1997 \R[C
Vestibulodynia
ZKEDFN \RP-NT ,
IRGPF
3 3
Vestibulitis N[ F[Y DGS-\\ \GKFN FNGMK Vestibulodynia
:|9,6~
Vulvar dermatoses Cyclic Candidiasis Squamous papillomatosis Vulvar vestibulitis Essential Vulvodynia FCKS BNN G[GZKV "Essential")
(3 (4 (5
.(FTGEK O K DGS - \ \
KM
,F [ KD EF
BKF
3
\NI\F NT TKV[FN NGMK EIB DGSC .ZIB DGS GBGNPC WNPGF BN FH DGGKS -GN[ QM[ ,B[GRC OKIPGPF KEK-NT ,\GHGJPZE ,OKRG[BZF OKCXPF \[ OKBXPKP OF ,SKHGJPGNKVVG \ZJV \GZK[K
OKP ZGD
\[DEF
,\ BH
ORKB[
OT
OK KBZY B
. FKZTC
CBMN
F\KKF FTGEK FCKS BNN FKRKEGGNGG-G SKJKNGCKJSG QKC \GRG[F \T F\GBP .OKRG[ NGVKJG \GCKS DGS NMN QM[ ,Z\GKC FCG[I
Vulvodynia N[ \GEZVR \C-\GXGCY K\[N OKZYGIF OKSIKK\P
{ KRGXKI KGZKD BNN ,KRGPXT ,L[GPP QVGBC FTKVGPF \BH
Vulvodynia IRGPF \B ZKEDFN ISSVD-F N[ OKXPBPF \GZPN
,
Z[YCG B[GRC OKZYGIF QKC \K\GTP[P FPMSF-KB FI\V\F
GH
,Z\GK
Vulvar
FIKM[F {
KEYGP
,FKR[F W IN
FXGCYFG GB
,
QKP-KSIK
Essential Vulvodynia OGKYC
F\KKF FRG[BZF FXNPFF :FPCFP GEZK L[PFC[ \GXNPF K\[
Dysesthetic vulvodynia
IRGPF
FKR[F FXNPFF .KCXTF OZGDF \B [KDEFN KEM
\B
UKNIFN
YZ .
GPSZV\F 1999 \R[C FZCIF \GSRM\FC[ ,LM KEM ET ,FRICBN
IR G PC
(2
:
\GPMSF-KB
Vulvar
(1
NGVKJF KMG ,CYGT QVGBC GB \KRPH
LMN USGRCG FKZTC TGCY CBM N[ \GRP\SF
.
UKNIFN
-GC ,EZVRC [IZ\FN OKNGMK FNB
{ \CNG[P \RGPSK\ OT OK[R \XGCY
KM ,F\KKF GR\IRF .|12~ (FKRGBZVSKE) QKP-KSIK OGKY \TC CBM
OD
Marilynne McKay FRG[BZN FIGGKE \GZIGBPF 70-F \GR[C Vulvodynia N[ \GXGCY-\\ [PI
Vulvodynia
OT OK[R KM FKF NCGYP .NGVKJC OD GNECR
NGVKJC GIKNXK
NT
áàë ìù çåðéîä úåçúôúä úøé÷ñî ç åðé îä úã òå åá í éð åéã äå ¬ äéø òá úåìçî ø÷çì äøáçä úàéìîáå Ðúôúä ìò ãåîìì ïúéð ¬ïãìäå äéøòä ìòå äæ êå áñ àùå ð á òãé ä úå ç áàëä úééòá ìù úéîìåòä äñéôúä ®äéøòá çðåîä ìù ùãçä âååéñä Ðäå ¬íå÷éî éôÐìò åìù íéâåñäÐúúå Ðéèáî äìà ìë Ñ éîå÷î õçìá êøåö äðçáà íéø÷åçì ïäå íéàôåøì ïä íéç ®äîéàúîå äãéçà áàëä úééòáì äãéçà äðçáà íåé÷ ¬àùåðá ø÷çîä êùîäì éðåéç äéøòá ¬áöîä ìù íéîøåâäå úåáéñä éåìéâì ®ìéòé ìåôéè çåúéôìå
\PGTN
\B
\GXGCY-\\N DGGKS
FNGIF .QKP
.FKZTC WIN \NTVF QPHC \GIGR
Dysesthetic vulvodynia
-C ,
vulva syndrome
Vulvodynia .|8~ QG[NC K\VGKEKB KRGZM CBMN SIKK\PF ,Glossodynia IRGPN Burning vulva IRGPC [GPK[F YSVGF FH IGRKP \NCYP FBXG\M .syndrome
OKKRGPXT OKCBM QKB \BHF \RGPSK\F OT \KSBNYF FNGIN -KSIK OGKYN QGKSKR GPM ,ZGHBC FNGTV GB OYGPP TDP QPHC BNB
,
IRGPF
FPGEC \BH { Q\NIPN OZGD BXPR BN[ \GNGIC
.SKJKNGCKJSG N[ \KP[ZF \GRP\SFN GMVF GNB OKEEP
KB
\R[CG
SYKZG\
McKay FTKXF 1992 \R[C .QKP-KSIK OGKYN Z[Y BNN ,FKZTC NT FXKNPF QM-GPM .OKRG[ OKPZGD GN Z[B ,FRICB BNG QKPS\ Dysesthetic IRGPC Essential Vulvodynia IRGPF \B UKNIFN Vulvodynia N[ OKCXP ZGBK\N Burning vulva syndrome IRGPF FVKZ[ \[DZFN" \SIKK\P Dysesthetic FNKPF QM[ ,vulvodynia OKB\P NGVKJ \GZPN GVNI BN[ GB ZGZC OZGD OFN QKB[
Essential (dysesthetic) Vulvodynia
FTKVGPF
vestibulitis
:'B FXGCY-\\
dysesthesia Vulvodynia NT FN[ OGSZKVC |9~ McKay FTKXF 1988 \R[C ZIBP ,Dysesthesia NBM Essential vulvodynia-N SIKK\FN
IRGPC [GPK[F \B NNM YKSVFN WNPGF[ LMC \KRMVFP F\KKF GTCJ[ ,FKRKEGNGCKJSG D[GPF \B WPBN GPGYPCG ,SKJKNGCKJSG IGRKPC
[GPK[F
\YSVFN
FCKSF
.|12~
'CIG
QKKJ[RZGC
,\YNE \GIMGR NT FEKTPF ,"SKJKB" \PGKSF BKF SKJKNGCKJSG .FNIPN \PZGD \YNE[ \T F\GBC IMGF BN F[TPN[ EGTC
-N FPGEC ,\KCXT \G[KDZP OKPZDR OKKPGYP \GIGR-KBG CBM[
Glossodynia-G Postherpetic neuralgia Essential OT \GNGIC \KRVGDF FYKECC OKK\GTP[P OKKGRK[ OKNI UZG[ TGCY KPGYP CBM NT \GRRGN\P QF KM QMG ,vulvodynia BN[ ,FTCY OD BKF .|9~
216
FBGVZF
(2006 SZP) 'D 'CGI ,145 LZM
SYKZG\
FKZTC CBMN
ISSVD2003 N[ DGGKSF :3 F N C J
FKZTC CBMN
:\KNGDS FTZVFN ZG[YF FKZTC CBM
.
:Vulvar dysesthesia
I
\YCN[ ,FEKERY :KPGFKH
(1
\KSGNGCGNGYKSG \NIP ,SGRNV QMKN :K\YNE
(2
[Y[Y KB\ \B[ ,J'DV \NIP :ZKBPP
(3
K\YCN[-Z\C GB K\YCN[ CBM :KCXT
(4
(
(
:Vulvodynia .II FKZTF NM \B CZTP :J[GVP OFKR[ GB KRKP BN TDP ,KRKP TDP :KPGYP WIN OT
'B
KRGPXT :KPGYP WIN KNC
'C
KPGYP WIN BNN OD OKKY LB ,KPGYP WIN \GCYTC TKVGP :CZGTP
'D
Vestibulodynia,)
FKZTF
N[
CKMZP (
GB
YN I
\GCZGTP
:KEYGP
Clitorodynia, Hemivulvodynia...
ISSVD 1999 N[ DGGKSF :1 F N C J
Dysesthetic Vulvodynia BZYR OEGYP) J[GVP
(1
:NNGMF KEYGP
(2
Vulvar vestibulitis BZYR OEGYP) Vestibulodynia Clitorodynia Vulvar dysesthesia N[ OKKEYGP OKZIB OKDGS
FKZTC CBMN
(1
ISSVD2001 N[ DGGKSF :2 F N C J :Vulvar dysesthesia
( (2
J[ G V P
'B
KEYGP
'C
Unprovoked) KPGYP WIN BNN KRGPXT QVGBC OZDRF CBM
OFKR[ GB KRKP BN TDP ,KRKP TDP :KPGYP WIN OT
'B
KRGPXT :KPGYP WIN KNC
'C
J[ G V P
'B
KPGYP WIN BNN OD OKKY LB ,KPGYP WIN \GCYTC TKVGP :CZGTP
'D
KEYGP
'C
CYTK
,LMN
FCGD\M
.1999
\R[N
OKPEGYF
OKIRGPN
FZCIF BK[R QDSM 2003=2001 OKR[F QKC QFKM[ ,
(
G ZH I
QKKJ[RZGC
\ETG
IR G PF
,FHN
USGRC
.QKY\
FKZT
BGCPP
FKSVGKCC
\K\YNE
ISSVD-F N[ FKDGNGRKPZJF International Classification of-C BXPR BN Vestibulitis .Disease (ICD-9) Manual KM
,FBXPG
FYEC
ICD-9-F NNGM CBMN \GZG[YF \GRICBG OKIRGP ,\GP[ "Pain Vulva"-G "vulvodynia" OKIRGPF KR[ KM ,FETGGF F\NTF KNGDS BN CBM" 625.9 EGYN \I\P ICD-9 ZVSC OKZEDGP
IGRKPF \ETG KEK-NT WPGB[ KVM "FKRKEGNGCKJSG" IRGPF
,"OKKCYRF
TCJR[M
OKZG[YF
OKZIB
OKRKPS\G
(KVKXVS)
Vulvar dysesthesia IRGPF \B BGXPN Z[VB KB O\PGTN YZ TKVGF Vulvar Dysesthesia .ZVSF N[ JSYJC BNG SYERKBC
BN ,
TCYR
Z[ B
FHP
.QKPF-KZCBN FH IRGPC \GSIKK\F F\KKF BN Z[BM ,WGXYKT
KP[Z
Vulvar dysesthesia IRGPF \B NJKC ISSVD QVGBC FZEDGF Vulvodynia .Vulvodynia
ZETKFC [IZ\PF ,UZG[ CBMM NNM-LZEC \ZBG\PF ,FKZTC
,OGYKP KV-NT \K[BZ :Vulvodynia IRGPF N[ DGGKSF ZES TCYR KGZKDC LZGXF KV-NT ,\KR[G
OGYKPF Z[BM .CBM YKVFN KEM
OZGDM KPGYP WIN \GIMGR \EKPG ,\K[BZF FYGNIF \B FGGFP :\KR[PF FYGNIF \B FGGFP CBMN
Dysesthetic IRGPF \B FVKNIP) Generalized Vulvodynia .FKZTF NM N[ \GCZGTPM \ZEDGP { (vulvodynia GB EEGC ZGHB \GCZGTPM \ZEDGP { Localized Vulvodynia
(1
(2
GB FKZT-KXI ,QDEDE ,FKZTF BGCP GPM ,FKZTF N[ CKMZP .(3 FNCJ) ZIB ZEDGP OGYP \G X GC Y -\ \N
OD
OKDGGSP
GN NF
QKKJ[RZGC
OGYPC
KEK-NT FRG[BZN
.ECNC SKJKNGCKJSG ZB\K[ IRGPM BNG CBMF \RGPSK\ DGGKS FKF 1999 \R[C SRMGF[ ZIB [GEKI BYGGE GBNG ,FYKECC \G[KDZF N[ YKGEPF FPGYKP KV-NT FKZTC
.(1 FNCJ) Z\GK OKZIGBPF
,USGRC ."\KDGNGZKR FTZVF GB ZKBPP LKNF\ ,\YNE ,KNGDS OGFKH
:N[
"SKJKNGCKJSG"
,\K\JSBSKE FKRKEGGNGG OT SKJKNGCKJSG N[ CZGTP CXP QKKVBN
-F ,IGRKPN FETGGF Z"GK N[ G\KIRFC 2003 N[ SRMC OKRGKEC
\GIGR-KBM"
BGF
OKIGRKPF NMC OD TKVGF FH [GEKI .F\TVGFN OZGDF KV-NT
KRMET IGRKP IRGPN ZGHIN TKXFG
FRG[
OKRGZIBF GRGGKM ZGYPC .|12~ 'CIG
FKF IRGPF .\GKZKZN BN LB ZGTN LKK[ BGFG ,782.0 EGY \I\ GB FVKZ[ ,\GZKYE ,NGPKR QGDM ,ZGTC \G[GI\C FTZVFM QKKVGBP
(2
OD BXPR FKZTF BGCPC OEGB KM ,\GEGCT ZVSPC ODEGF ,F[TPN
CBMN IGRKPF \ETG KZCI \B FIRF ,IGRKPF \ETG [BZ C[GKG
QKPF-KZCBN
(1
FRRSF BGXPN Q\KR KM QMG ,\GKRKPS\-KB \GBKZC OK[R CZYC
N[ FZKYS TXCNG CBM IGRKPN OKIPGP OT WTKK\FN FKZTC LM CYT .
217
Provoked) KPGYP WIN OT OZDRF CBM
OKKGJKCF
KR[
Unprovoked ;(OFKR[ GB KRKP BN TDP ,KRKP TDP) Provoked .(Provoked-G Unprovoked N[ CGNK[) Mixed GB (KRGPXT)
\GKRPH \GPMSF OKIGRKPF \BG 1999 \R[ N[ IGRKPF \B F\GGKN[ \VSGR FTVG\ OKK\GTP[PF \GTEF-KYGNKI CYT :O\GKRPHC FZMFF BKF OKBCF NM ,QENFG FKZTF \GNIP ZYIN \KPGBNRKCF FZCIF KDKFRP QKC OT QFN[ IGRKPF \TXF \B GNKCDF 2003-N 1999 QKC \GETGGF ,LK[PFN OK[YC\P FZCIF KZCI[ KRPH IGRKP GFH KM FZMFF OTV GRGEK GC[ FZCIF N[ BCF SRMF \BZYN CKDFNG NGY[N ,QGKEN B[GRF CG[ FNTGF 2001 \R[C SRMC ,ORPGBG .\VSGR KRGXKI KGZKD \GIMGR B[GR \B FEEKI[ FSKV\F FSRMGF FH CN[CG OZGDF KPGYP WIN BNN CBM \TVGF GB ( [EI
KRPH DGGKS QY\GF
Provoked) CBMN OZGDM Unprovoked) CBMN
FH SRMC OD .(
QF { IGRKPF \ETG N[ \G[KV\F K\[ N[ CGNK[F NT SSC\PF GPGYKP QFG CBMN OZGDF KPGYP WIN N[ \GIMGR-KB-\GIMGR .(2 FNCJ) QGXZ \GTKC[-KB \PKKY KM ,ZZC\F 2003 N[ KPNGTF SRMC SRMR BN 2001 N[ DGGKSF[ LMC FBJC\F[ ,FZCIF KZCI CZYC ,GPXT
ISSVD-FP
OKZCI NNGM ,OKCZ OKBVGZG ,CIZR [GPK[N
FBGVZF
(2006 SZP) 'D 'CGI ,145 LZM
,F[KBF \GBKZCN UDBF ,
QKKJ[RZGC CYTK
:C\GMPF ZCIPF
22100 FKKZFR ,21 .E.\ ,KCZTPF NKNDN OKNGIF-\KC 04=9001890 :SYV ,050=7887631 :QGVNJ
[email protected]
:N"BGE
Localized provoked vulvodynia ,QM-NT-Z\K Vestibulitis FBZYR
H B E T Z[ B )
ZG[YF KRKP TDPC CBMM [EIP FZEDGF (
CBM OD \NNGM \BH FZEDF .FKZTC TDPF OT \GIGR-KB \[DZFN \YKEC ,QGVPJ \ZEIF ,YGEF EGDKC GPM TDP DGS NMN FCGD\C
Cotton tip test) ZPX FXY
.'GEMG \GTCXBF FXY N[ TDP ,(
,SRMGF ,FRGP\F \B OKN[FN KEM KM ,OD ODEGP 3 FNCJC
Vulvodynia-N
OKPZGDF ZKXY\ OD ,
OKPZGDF OKCXPFP EZVRC
OKZKBPP ,OKK\YNE ,OKKPGFKH OKPZGD GPM FKZTC ,CBMN OKKNGDSF .OKKCXT GB FMH 2003 \R[C
ISSVD KEK-NT ,TCYR[ IGRKPF
OGMKSN
,
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3. Skene AJC, Treatise on the disease of women. New York, D Appleton and Company, 1889. 4. Kelly HA, Gynecology. New York, D Appleton and Company, 1928. 5. Moyal-Barracco M & Lynch P, 2003 ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med, 2004; 49: 772-777. 6. Chris Veasley & Stanley Marinoff, The evolution of vulvodynia terminology: clarifying the issue. NVA News; Summer 2004. 7. Tovell MM & Young AW Jr, Classification of vulvar disease. Clin Obstet Gynecol, 1978; 21: 955-961. 8. Lynch PJ, Vulvodynia: a syndrome of unexplained vulvar pain, psychologic disability and sexual dysfunction: The 1985 ISSVD presidential address. J Reprod Med, 1986; 31: 773-780. 9. McKay M, Subsets of vulvodynia. J Reprod Med, 1988; 33: 695698. 10. McKay M, Vulvodynia. Diagnostic patterns. Dermatol Clin, 1992; 10: 423-433. 11. Friedrich BG Jr, Vulvar vesstibulitis syndrome. J Reprod Med, 1987; 32: 110-114. 12. Bornstein J, Vestibulodynia ± a subset of vulvar vestibulitis or a novel syndrome. Am J Obstet Gynecol, 1997; 177: 1439-1443.
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chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? J Am Med Women's Assoc, 2003; 58: 82-88. 2. Thomas TG, Practical Treatise on the Diseases of Women. Philadelphia, Henry C Lea's Son & Co, 1880, pp 145-147.
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