(056) PSYCHOSOCIAL FACTORS IN NEUROPROLIFERATIVE VESTIBULODYNIA PATIENTS WHO UNDERWENT COMPLETE VESTIBULECTOMY
Notice bibliographique
Résumé
Abstract Introduction Neuroproliferative vestibulodynia (NPV) is characterized by severe allodynia and hyperalgesia during entry penetration. Multiple psychosocial factors may contribute to the experience of pain from NPV. Concerning psychologic factors, women afflicted with NPV report difficulty with mental health issues such as anxiety and depression, high rates of negative emotions, substantial difficulties with psychosocial adjustment, and experience suicidal ideation. Objective This study focuses on psychosocial factors identified in a cohort of patients diagnosed with NPV who underwent vestibulectomy. Methods This is a chart review of 65 patients, median age 26 years (IQR 23-31) clinically diagnosed and pathologically confirmed with NPV. They completed validated instruments administered including the Female Sexual Function Index (FSFI), Sexual Distress Scale-Revised (SDS-R), McGill Pain Questionnaire-Short Form (SF-MPQ), Perceived Stress Scale (PSS), and Patient Health Questionnaire-9 (PHQ-9). The sex therapy evaluation performed on initial patient intake assessed psychosocial issues including effect of symptoms on quality of life, self-image, past trauma, and past/current relationship(s). Patients identified as having significant psychosocial issues were advised to undergo pre-op and/or post-op therapy. Results Based on history, initial psychological assessment, and psychosocial experiences with vestibular pain, post-operative therapy was recommended to 94% of our study cohort to maximize post-operative outcome. Our study cohort exhibited high levels of anxiety (53.8%) and depression (50.8%). Sexual abuse, assault and/or incest had been experienced by 32.3%. Other psychological issues included eating disorder (10.8%), bipolar (6.2%) as well as suicidal ideation (4.6%). Problems revolving around personal relationships include panic attacks around sex/men (21.5%), not pursuing sexual relationships (9.2%), lack of attraction toward current partner (4.6%) or being attracted to unavailable people (3.1%). A total of 15.4% of this cohort had complaints of low desire and 9.2% had a history of drug or alcohol abuse. Median FSFI total score was 13/36 (<26), with distress (≥11) consistent with sexual dysfunction in 56 of 61 patients. Median FSFI pain domain was 0/6; median FSDS-R (n=61) was 35/52, indicative of significant distress; median PHQ-9 was 6.5/27 with 23 patients’ scores consistent with possible need for depression treatment based on clinical judgment and 14 patients with score consistent with warranting treatment for depression. Median PSS was 22/40 with the most common level of stress being moderate (n=54). SF-MPQ median results (n=63) were 15/33 for sensory, 3/12 for affective and 4/5 for present pain intensity. With 3-46 month follow-up, 86.3% of patients (44/51) reported improvement on the Patient Global Impression of Improvement with 72.5% (37/51) reporting significant improvement. Conclusions While NPV is a biologic diagnosis, psychological factors likely contribute to the development, continuation, and consequences of NPV. We believe that the significant mental health issues in this NPV patient population made recovery from vestibulectomy more protracted than typically experienced after surgery. Psychological therapy would be beneficial in this population and should be continued postoperatively, as needed, to address psychological concerns and enhance quality of life. Disclosure No.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».