Establishing the diagnosis of vulvar vestibulitis
White, G.; Jantos, M.; Glazer, H.
Journal of Reproductive Medicine 42(3): 157-160
1997
ISSN/ISBN: 0024-7758 PMID: 9109083 Document Number: 482659
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 mu-V) in 23 (71%); poor contractile potential, lt 17 mu-V, in 20 (65%); elevated resting standard derivation, gt 0.20, in 30 (93%); slow to poor recruitment recovery after contraction, gtoreq 0.2 seconds in 27 (86%) and low frequency, lt 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.