Sacral Neuromodulation in the Treatment of Vulvar Vestibulitis Syndrome

BACKGROUND: Vulvar vestibular syndrome is a chronic pain syndrome that typically results in pain and irritation of the vulvar vestibule and has few effective options for treatment. CASE: A 42-year-old woman presented with symptoms consistent with chronic vulvar vestibular syndrome that was refractory to multiple attempted therapies. The patient was offered sacral neuromodulation for treatment. She underwent a standard two-phase surgical implantation with good result at 2 years postimplantation. CONCLUSION: Sacral neuromodulation was shown to be a valid treatment option for this patient and resulted in excellent patient satisfaction at 2-year follow-up. Although the exact mechanism of action is unknown, sacral neuromodulation may be a viable option for the management of chronic pain syndromes of the vulva and vagina. (Obstet Gynecol 2009;114:487-9)