Treatment of Vulvodynia by Lumbar Sympathetic Block -A case report-

Although chronic unexplained vulvar pain is a highly prevalent disorder, it is often mis- and under-diagnosed. Vulvodynia is a complex pain syndrome with few effective treatments. We present a case of vulvodynia which was effectively managed by a lumbar sympathetic ganglionic block (LSGB). A 70-year-old woman with a long burning and pulsatile vulvar pain of 3 years duration visited our pain clinic. Her pain by the visual analog scale was 10 out of 10 and her symptom was associated with anorexia, sleep disturbance, weight loss, and chronic fatigue. No abnormalities were evident in laboratory findings or imaginary views. After she was prescribed with amitriptyline, gabapentine, and benzodiazepine, her symptom reduced slightly. She was then admitted and received LSGB, with significant pain relief. LSGB may offer an alternative treatment modality for woman for vulvodynia.