Terapia regenerativa combinada en vulvodinia traumática postoperatoria: reporte de un caso

Vulvodynia is a pathology characterized by chronic vulvar pain, with no defined cause, classified as generalized or localized, depending on the presence or absence of pain stimuli. It is difficult to manage with very low cure or improvement rates. This does not mean, however, that new alternative therapies are undertaken to reduce pain and restore sexual function, among other conditions.  This clinical case study evaluated the effectiveness of combined regenerative therapy in post-operative traumatic vulvodynia in a 25-year-old nulliparous female patient with no comorbidity history; she was evaluated one-year post-surgery for vulvar and perineal trauma in the Pelvic Floor Rehabilitation Unit (PFRU) for presenting severe vulvar pain, urinary and fecal incontinence, without active sexual life. With prior informed consent, she was treated for severe pain (8 - 10) measured on the Visual Analog Scale (VAS); combined regenerative therapy was applied in-office which included: three sessions every 21 days of vaginal tightening with CO₂ laser and platelet-rich plasma; 10 sessions of shockwave therapy and 14 sessions of pelvic floor rehabilitation with electromagnetic chair. After the third week of therapy, pain progressively decreased, with patient reporting improvement related to urinary and fecal incontinence; she initiated an active sexual life without pain. It was concluded that the therapy is effective in eliminating vulvovaginal and perineal pain; it is a non-invasive, painless procedure that regenerates and strengthens the pelvic floor muscles.