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Ursula Wesselmann, MD, PhD
Johns Hopkins University
Mechanisms of Vulvodynia
Abstract: DESCRIPTION: (provided by applicant) The long range objective
of this research is to elucidate the pathophysiological mechanisms
of vulvodynia, a chronic pain syndrome of the vaginal and vulvar
area, in order to develop improved treatment strategies for alleviating
chronic pain in these women, targeted at the underlying pathophysiological
mechanisms. Vulvodynia is a major challenge for women who suffer
from this chronic pain syndrome, and has a detrimental impact on
their sexual lives. Treatment strategies, including medical and
surgical approaches, are empirical only and are often unsuccessful.
We propose two approaches to gain a better understanding of the
pathophysiological mechanisms of vulvodynia: (1) We will develop
an animal model in the rat, that will allow to study the spinal
cord pathways involved in the processing of noxious input from the
vagina. The specific goals of this animal research project are (a)
to obtain detailed information about the spinal cord pathways that
process nociceptive afferent input from the vaginal area, (b) to
determine the influence of the estrous cycle on the spinal cord
processing of noxious vaginal stimulation, (c) to assess the effects
of pharmacological agents on the spinal cord processing of noxious
vaginal stimulation, (d) to study the influence of previous vaginal/vulvar
trauma on the response to noxious vaginal stimulation. (2) We propose
to characterize pain in patients with vulvodynia in detail. Our
hypothesis is that patients with vulvodynia can be differentiated
into distinct groups based on their pain characteristics, and that
treatment of pain in vulvodynia will be more effective, if based
on recognition of the underlying neurophysiological mechanisms.
The specific goals of this clinical research project are to (a)
to assess the response to non-noxious and noxious stimuli in the
vulvar and vaginal area in women suffering from vulvodynia in comparison
to healthy controls using quantitative sensory testing, (b) to determine
the influence of the gonadal hormonal milieu on pain in patients
with vulvodynia. These studies will provide fundamental new insights
into the pathophysiological mechanisms of vulvodynia. The results
of these studies may rapidly contribute to the design of new treatment
strategies specifically targeted at the underlying neural mechanisms
of chronic pain in women with vulvodynia.
back to NIH Funding
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