Establishing the Diagnosis of Vulvar Vestibulitis
Gordon White, F.A.C. Ven., M.H.P., M.F.P.H.M., Marek Jantos, M.A., M.A.Ps.S.,
M.A.I.M., and Howard Glazer, Ph.D. Objective:
To study the pelvic floor electromyographic (EMG) responses of a cohort of patients
diagnosed with vulvar vestibulitis.
Study Design: Following full medical and laboratory workup, patients with
vestibulitis were given pelvic floor EMG. Results were compared with the collated data,
termed the "nonmorbid EMG pelvic floor response," derived from a study control
group of 50 symptomless subjects. Six aspects of the EMG response were examined: resting
baseline, contractile potential, resting standard deviation, recruitment, recruitment
recovery and power spectral analysis.
Results: As compared to the study control group, the cohort demonstrated elevated
resting baseline above 2.0 mV) in 23 (71%); poor contractile potential, < 17 mV, in 20
(65%); elevated resting standard deviation, > 0.20, in 30 (93%); slow to poor
recruitment recovery after contraction, _0.2 seconds in 27 (86%) and low frequency,
<115 Hz in 22 (69%).
Conclusion: The study confirmed that of vestibulitis patients, 88% will
show at least three of the above altered criteria and that the diagnosis can be confirmed
by: (1) the instability of muscle, (2) poor muscle recovery after contraction, and (3)
elevated resting baseline plus one other optional criterion, either (4) reduced frequency
or (5) reduced muscle contraction strength. (J Reprod Med 1997;42:157-160)
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