Spinal cord stimulator for the treatment of a woman with vulvovaginal burning and deep pelvic pain

BACKGROUND: Vulvoclynia is a chronic pain disorder of the vulva that occurs in the absence of visible infectious, inflammatory, neoplastic, or neurological findings. Multiple treatment modalities are used, often with insufficient results. We report the successful use of a spinal cord stimulator to treat vulvoclynia symptoms in a patient who had unsuccessful prior conservative therapies. CASE: A postmenopausal woman presented with 15 years of treatment for vulvar and vaginal burning and deep pelvic pain. She had been taking multiple pain medications with inadequate relief. After successful test stimulation, a permanent spinal cord stimulator was implanted. At 10 months posttreatment, her pain improved by 80%, and the patient no longer requires oral medication. CONCLUSION: The use of spinal cord stimulation was successful in a patient with vulvodynia and unsuccessful multiple prior therapies and whose symptoms were diffuse in nature.