Electrodiagnostic Functional Sensory Evaluation of Patients With Generalized Vulvodynia

In Brief Objective: To objectively evaluate vulvodynia by the current perception threshold (CPT) neurometer. Methods: Neuroselective CPT measures of the pudendal nerve were obtained at the perineum by a neurometer (Neurotron, Inc, Baltimore, MD), using constant alternating sinusoid waveform electrical stimulus at 2,000-, 250-, and 5-Hz frequencies, in 20 healthy volunteers and 38 women with vulvodynia. The mean ± SD CPT values in vulvodynia and healthy (control) women were analyzed with the Student t test. Results: Women with vulvodynia showed lower mean CPT values (p <.01). Conclusions: Results of this study support a neuroselective sensory dysfunction in generalized vulvodynia. The field is opened for CPT measures in vulvodynia in selecting therapy strategy, monitoring response to treatment, and assessing vestibulodynia. Assessment of threshold values in a greater number of controls is needed to set a cutoff in CPT values for diagnosis and to grade the severity of the diseases. The current perception threshold shows hypersensitivity of the pudendal nerve, supporting the neuropathic hypothesis of a neuroselective sensory dysfunction for the pain in generalized vulvodynia.