Vulvodynia and Concomitant Femoro-Acetabular Impingement: Long-Term Follow-up After Hip Arthroscopy

Objective We hypothesized that in patients with vulvodynia and femoro-acetabular impingement (FAI), vulvar pain may be generated by the effect of FAI on pelvic floor structures, and treatment with arthroscopy may improve vulvodynia. We also sought to identify characteristics of patients whose vulvodynia improved after arthroscopy. Materials and Methods A case series of patients with vulvodynia and FAI underwent physical therapy, and, if hip symptoms did not improve, arthroscopy. Three to 5 years postoperatively, follow-up of outcomes after arthroscopy on vulvodynia was performed using chart review and patient questionnaire. Clinical characteristics and pain scores describing patients with and without vulvodynia improvement were assessed. Results Twenty-six patients with generalized unprovoked vulvodynia (GUV) or clitorodynia underwent arthroscopy for FAI. Six patients, all younger than 30 years, experienced lasting improvement in vulvodynia. Twenty patients, with an older mean age, longer mean vulvodynia duration, and mainly severe pain scores, did not experience vulvar pain improvement after arthroscopy. Conclusion This case series describes improved vulvodynia outcomes after arthroscopy for FAI in women younger than 30 years. Patients with vulvar pain and coexisting FAI had GUV and clitorodynia.