Vaginismus: an important factor in the evaluation and management of vulvar vestibulitis syndrome.

Dyspareunia is a common complaint in general gynecological practice. Many patients with dyspareunia suffer from vulvar vestibulitis syndrome (VVS). This syndrome constitutes severe pain on vestibular contact or attempted vaginal entry, tenderness to pressure within the vulvar vestibule and physical findings of vulvar erythema of various degrees. As a last resort, and only when all conservative treatments have failed, surgery is attempted. It has been our observation that a considerable percentage of patients with VVS present with concomitant vaginismus. Furthermore, surgery is less successful in this subgroup of patients unless the vaginismus is first treated. This report describes the evaluation and treatment of 14 patients with VVS.