cystitis and vulvodynia

[Diane__0__0]

  I have suffered from vulvodynia for a long time. I've done all the regular things like experiment with anti-depressants, low-oxylate diet, xylocaine, etc.  Periodically, I also have all the symptoms of a UTI.  When I go to my internist, no infection shows up.  However, I have read that IC and vulvodynia often exist together.  I have read a lot about both conditions.  I went to a urologist with my concerns that perhaps my urinary frequency, discomfort was somehow related to the vulvodynia.  He did a urinalysis, saw no sign of infection, and promptly dismissed me and my concerns.  Is there a possible link between these two conditions so that even though no infection shows in my urine, something really is there?  Is there a medical specialty that combines gynecology and urology?  If so, where could I get a directory of those doctors?  Thanks very much!
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Dear Diane
Thanks for your question.
Vulvar vestibulitis syndrome is a condition which has symptoms isolated only to the vulvar vestibule ( the outer portion or opening of the vagina ).  This disease process incorporates vulvodynia.  The symptoms experienced with this syndrome include; severe pain on vestibular touch to attempted vaginal entry, tenderness to pressure localized within the vestibule and redness of this region on examination.   One study of 36 patients with vulvitis about 11 had IC.  
Missing the diagnosis is always a possibility so it is important to have regular appointments with a doctor who has an understanding of such a rare disease process. There is no formal directory of doctors who treat such a rare disease as vulvodynia.  You may want to try your local gynecologist or the authors listed below. Of course you will have to look up the articles to know the institutions in which they practice.
   You will find many more doctors who see IC patients.  I would recommend checking with your local urology group  or medical association for urologist who  specializes in IC.  He /she may check for a concurrent diagnosis of IC and begin treatment which may help both conditions. There is the subspecialty of female urology and more and more academic institutions have such represented in their departments.  
Further literature on your condition :  Marinoff SC , Turner MLC :  Vulvar Vestibulitis Syndrome: an overview. J Obstetrics and Gynecology 1991;  165: 1228-1234
McCormick, WM Two Urogenital Sinus Syndromes, Interstitial Cystitis and Focal Vulvitis . J Reporductive Medicine 1990; 35: 873-876
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you  may be able to obtain. These will help us greatly.
Good Luck
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword: Vulvodynia, Vulvar Vestibulitis Syndrome, Interstitial Cystitis