English Polski
Vol 18 (2020): Continuous Publishing
Research paper
Published online: 2020-12-01

open access

Page views 1125
Article views/downloads 548
Get Citation

Connect on Social Media

Connect on Social Media

Is Recover therapy effective in reducing pain in women with vulvodynia?

Ewa Baszak-Radomańska1, Jadwiga Wańczyk-Baszak2, Marta Nowosad1, Joanna Sawka, Agnieszka Mazurkiewicz1, Karolina Ochnik-Bąk1, Paweł Malicki1
Seksuologia Polska 2020;18.


Introduction: Vulvodynia (Vd) is a form of chronic vulvar pain and other discomfort that persists for more
than three months in the absence of any evident vulvovaginal pathology. Provoked Vd is one of the reasons
of dyspareunia. Vd is classified as a functional pain syndrome that is mediated by pelvic floor muscles
dysfunction (PFMD overactive state) and psychological predisposition. Treatment standards do not exist,
although multidisciplinary therapy seems to be the most effective.

Material and methods: Retrospective study was performed within 121 women with Vd who undergo Recover
therapy. Nineteen therapeutic sessions were included, with manual pelvic therapy, initial general physiotherapy
and psychological consultations performed during minimum 5 days. Vd patients with PFMD overactive
state were qualified by a gynecologist to the therapy, who also summarizes the treatment. Pain rate and
characteristics of vulvar discomfort were assessed before and 2 and 6 months after therapy, recorded in NRS.

Results: Vulvar pain and discomfort subjective reduction by 65% was confirmed after therapy, even more,
2/3 of women reported a minimum 50% relief in pain, the improvements were maintained over the time.
The best treatment results in dyspareunia women caused by provoked Vd were obtained. The outcome was
not dependent on the duration of Vd.

Conclusions: In the center when women with vulvar diseases and Vd are treated, interdisciplinary Vd therapeutic
program was developed. Recover therapy can lead to clinically meaningful improvement in Vd
pain, according to chronic pain therapy assessment criteria. Randomized clinical trial with control group
is indicated, when other key parameters of IMMPACT consensus, for Recover therapy assessment, would
be taken under consideration.

Article available in PDF format

View PDF (Polish) Download PDF file


  1. Bornstein J, Goldstein AT, Stockdale CK, et al. consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Womenʼs Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS). 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. J Low Genit Tract Dis. 2016; 20(2): 126–130.
  2. Jantos MA. Myofascial perspective on chronic urogenital pain in women. In: Santoro GA, Wieczorek AP, Bartram C. ed. Pelvic floor disorders . Springer 2021.
  3. Reissing ED, Brown C, Lord MJ, et al. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. J Psychosom Obstet Gynaecol. 2005; 26: 107–113.
  4. Bo K, Frawley HC, Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurourol Urodyn. 2017; 36(2): 221–244.
  5. Hartmann D, Sarton J. Chronic pelvic floor dysfunction. Best Pract Res Clin Obstet Gynaecol. 2014; 28(7): 977–990.
  6. Bergeron S, Reed BD, Wesselmann U, et al. Vulvodynia. Nat Rev Dis Primers. 2020; 6(36): 1–20.
  7. Faubion SS, Shuster LT, Bharucha AE. Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clin Proc. 2012; 87(2): 187–193.
  8. Goldstein AT. Pain, and pelvic pain. In: Goldstein AT, Pukall CF. ed. Female sexual pain disorders: evaluation and management. John Wiley & Sons Ltd. 2020.
  9. Lee N, Jakes A, Lloyd J, et al. Dyspareunia. BMJ. 2018: k2341.
  10. Goldstein AT, Pukall CF, Brown C, et al. Vulvodynia: assessment and treatment. J Sex Med. 2016; 13(4): 572–590.
  11. Rosen NO, Dawson SJ, Brooks M, et al. Treatment of vulvodynia: pharmacological and non-pharmacological approaches. Drugs. 2019; 79(5): 483–493.
  12. Sorensen J, Bautista KE, Lamvu G, et al. Evaluation and treatment of female sexual pain: a clinical review. Cureus. 2018; 10(3): e2379.
  13. Goldfinger C, Pukall CF, Thibault-Gagnon S, et al. Effectiveness of Cognitive-Behavioral Therapy and Physical Therapy for Provoked Vestibulodynia: A Randomized Pilot Study. J Sex Med. 2016; 13(1): 88–94.
  14. Lewis GN, Bean D, Mowat R. How Have Chronic Pain Management Programs Progressed? A Mapping Review. Pain Pract. 2019; 19(7): 767–784.
  15. ACPA Resource Guide to Pain Medication and Treatment. https://www.theacpa.org/pain-management-tools/resource-ghttps://www.theacpa.org/wp-content/uploads/2019/02/ACPA_Resource_Guide_2019.pdfuide-to-chronic-pain-treatments/.
  16. Baszak-Radomańska E, Wańczyk-Baszak J. Farmakoterapia zaburzeń seksualnych związanych z bólem. In: Depko A, Mamcarz A. ed. Farmakoterapia zaburzeń seksualnych. PZWL w druku.
  17. Sadownik LA, Yong PJ, Smith KB. Systematic Review of Treatment Outcome Measures for Vulvodynia. J Low Genit Tract Dis. 2018; 22(3): 251–259.
  18. Pukall CF, Bergeron S, Brown C, et al. Vulvodynia Collaborative Research Group. Recommendations for Self-Report Outcome Measures in Vulvodynia Clinical Trials. Clin J Pain. 2017; 33(8): 756–765.
  19. Corsini-Munt S, Rancourt KM, Dubé JP, et al. Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. J Pain Res. 2017; 10: 2425–2436.
  20. Baszak-Radomańska E, Wańczyk-Baszak J, Paszkowski T. Pilot study of testing a clinical tool for pelvic physical examination in patients with vulvodynia. Ginekol Pol. w druku.
  21. Pereira G, Soriano Marcolino M, Silveira Nogueira Reis Z, et al. A systematic review of drug treatment of vulvodynia: evidence of a strong placebo effect. BJOG. 2018; 125(10): 1216–1224.
  22. Davenport RB, Voutier CR, Veysey EC. Outcome Measurement Instruments for Provoked Vulvodynia: A Systematic Review. J Low Genit Tract Dis. 2018; 22(4): 396–404.
  23. Brotto LA, Yong P, Smith KB, et al. Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. J Sex Med. 2015; 12(1): 238–247.
  24. Potente C, Giraudo D, Palleshi G, et al. Evaluation of the effectiveness of rehabilitation treatment in patients with chronic pelvic pain: a systematic review. Pelviperineology. 2019; 38(3): 70–77.
  25. Lev-Sagie A, Kopitman A, Brzezinski A. Low-Level Laser Therapy for the Treatment of Provoked Vestibulodynia — A Randomized, Placebo-Controlled Pilot Trial. J Sex Med. 2017; 14(11): 1403–1411.
  26. Reed BD, Harlow SD, Plegue MA, et al. Remission, Relapse, and Persistence of Vulvodynia: A Longitudinal Population-Based Study. J Womens Health (Larchmt). 2016; 25(3): 276–283.

Journal of Sexual and Mental Health