For vulvar vestibulitis, 5% lidocaine found effective.(Gynecology)

CHICAGO -- Long-term use of 5% lidocaine ointment shows promise as a treatment for the management of vulvar vestibulitis, vaginal apex pain, and intrinsic cervical pain, Dr. John Steege said at a meeting sponsored by the International Pelvic Pain Society.

"We started out with vestibulitis pain and moved on to vaginal apex pain, and overnight lidocaine works pretty well," said Dr. Steege of the division of advanced laparoscopic and gynecologic surgery at the University of North Carolina, Chapel Hill. "We've done 52 vaginal apex revisions, but we've slowed down on that in the last few years because the overnight lidocaine works pretty well."

Dr. Steege credits colleague Dr. Dennis Zolnoun, of the department of ob.gyn. at the university, for the thinking behind the treatment. In a small study last year, Dr. Zolnoun and colleagues treated 61 women who presented with introital pain and met the criteria for vulvar vestibulitis.

After a mean of 7 weeks of nightly treatment with 5% lidocaine ointment, 76% of women reported the ability to have intercourse, compared with 36% before treatment. Intercourse-related pain score was 39 points on a 100-mm visual analog scale after treatment, with a decrease of 10 points in daily pain score.