VSIL terminology: The introduction of the LAST raised two concerns in relation to vulvar lesions: the absence of reference to "differentiated VIN". Secondly, including the term: 'low grade squamous intraepithelial lesion' (LSIL) in LAST recreated the potential for over-diagnosis.
Vulvar pain and Vulvodynia: New research led to better understanding of the physiology and pathogenesis.
VSIL terrminology: The terminology committee of the ISSVD discussed several new terminology options.
Vulvar pain and Vulvodynia: The ISSVD, together with ISSWSH and IPPS held a consensus conference.
VSIL terminology:
• Vulvar LSIL, encompassing flat condyloma or HPV effect
• Vulvar HSIL (VIN usual type)
• VIN, differentiated-type (DVIN)
2015 Consensus terminology and classification of persistent vulvar pain and vulvodynia
A. Vulvar pain caused by a specific disorder*
• Infectious
• Inflammatory
• Neoplastic
• Neurologic
• Trauma
• Iatrogenic
• Hormonal deficiencies
B. Vulvodynia – Vulvar pain of at least 3 months' duration, without clear identifiable cause, which may have potential associated factors
Descriptors:
• Localized or Generalized or Mixed (localized and generalized)
• Provoked or Spontaneous or Mixed (provoked and spontaneous)
• Onset (primary or secondary)
• Temporal pattern (intermittent, persistent, constant, immediate, delayed)
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*Women may have both a specific disorder (e.g. lichen sclerosus) and vulvodynia
2015 Consensus terminology and classification of persistent vulvar pain and vulvodynia
Appendix: Potential factors associated with Vulvodynia*
• Co-morbidities and other pain syndromes [Level of evidence 2]
• Genetics [Level of evidence 2]
• Hormonal factors (e.g. pharmacologically induced) [Level of evidence 2]
• Inflammation [Level of evidence 2]
• Musculoskeletal [Level of evidence 2]
• Neurologic mechanisms:
- Central (spine, brain) [Level of evidence 2]
- Peripheral – Neuroproliferation [Level of evidence 2]
• Psychosocial factors [Level of evidence 2]
• Structural defects [Level of evidence 3]
VSIL terrminology: The new terminology includes all types of vulvar squamous intraepithelial lesionsand create unity among clinicians and pathologists.
Vulvar pain and Vulvodynia: The new terminology incorporates new information derived from evidence-based studies conducted since the last terminology introduced in 2003.