Vulvodynia, the first public clinic in Italy opens in Bari

It can strike at all ages, from adolescence to menopause, and can sometimes become permanent causing various symptoms including vaginal burning, frequent inflammation and dyspareuniai.e. pain during intercourse. From the vulvodynia there has (fortunately) been talked about a lot in recent months, also thanks to the awareness of some influencers such as Giorgia Soleri, who last May supported a law proposal to bring the pathology back, together with the pudendal neuropathy (a suffering of the nerve fibers of the pudendal nerve), moles essential levels of assistance in the national health system.

atSan Paolo hospital in Bari born now, pending a provision on a national scale, the first public clinic dedicated to the treatment of vulvodyniawhich instead is a persistent pain at the entrance to the vagina and in the area that surrounds it, the vulva, as explained by the Istituto Superiore di Sanità “without any sign or visible lesion to justify it”.

“These are pathologies with a strong clinical and social impact, multifactorial and highly disabling – explains a note from the ASL of Bari – which frequently concern very young women and have a diagnostic delay that can reach 12 years in many cases”. The specialist surgery was titled Pelvic perineal wellness clinic for women and belongs to the complex operating unit of obstetrics and gynecology of the San Paolo. The manager is the doctor Rosanna Zaccaro. He also participated in the activation of the clinic Clare Christmasone of the patient activists of the Vulvodynia and pudendal neuropathy committee who precisely elaborated the bill presented last spring with Soleri.

The commitment of the Puglia region for gender medicine

“This is another facility of gender medicine that was born in Puglia, one of the first in Italy – commented the president of Puglia Michele Emiliano – Here at the San Paolo hospital, a new center of excellence for women’s health has come to life, for pathologies for which there are still very few references in the public structures of our country. Gender medicine makes available to women everything they need to live in health, so for us another important goal is achieved in this direction”.
In this sense, Puglia stands alongside Natale and Soleri: the president of the regional council Loredana Caponetogether with the adviser Marcus Galantehas in fact written and deposited a motion which commits the Regional Council to act as spokesman towards the national government of the urgency of recognizing not only vulvodynia and pudendal neuropathy but also endometriosis, adenomyosis And fibromyalgia as disabling diseases, which give the right to exemption from sharing in the cost of health services.

The regional motion also aims to identify on the national territory both public health structures suitable for diagnosis and rehabilitation and research centers for continuous study and training. «But there is more – added Capone – because together with the rectors of the Apulian universities we are working on a training course within the university structures, so that the symptoms can be immediately recognized and so that those affected no longer feel alone and different”.

Vulvodynia, until a few years ago a disease considered “imaginary”

Vulvodynia was recently recognized by the World Health Organization in the latest revision of the International Classification of Diseases and falls into the category: «pain related to the vulva, vagina or pelvic floor». Although little known, it is by no means a rare disease: indeed it is prevalent between 12 and 16% of the female population, therefore superior to other certainly better known diseases such as fibromyalgia and endometriosis, which have a prevalence of approximately 5 and 10% respectively. Yet, for years – and still today – it was considered an “imaginary” disease. The scientific community has it recognized as a disease only in 2003.

«The first public clinic that deals with vulvodynia – commented Natale – is like pure gold for us, being treated is expensive, so knowing that from today, among other things, in the South, therefore it is an added value, there is a structured point of reference is essential, and we hope that it will be a replicable example not only in Puglia but also in other regions ». The clinic is coordinated by doctors, midwives, physiotherapists and a multidisciplinary team made up of: pathologist, rheumatologist, psychologist/psychiatrist, urologist, gastroenterologist, neurologist, immunotransfusionist, pain therapist and dermatologist.

As the health director of the Bari Asl explains Danny Sivo, the clinic is “able to guarantee the complete care of women affected by these disabling pathologies through an integrated multidisciplinary approach and capable of relating, where necessary, also with other specialized structures in order to guarantee the best quality of life. Once you get past the initial stage of work in progress the ultimate goal of the project is to set up a real one pelvic unita multidisciplinary service aimed at the diagnosis and treatment of pathologies of the pelvic organs and the pelvic floor».

What is vulvodynia

Vulvodynia frequently affects the age group between 20 and 40 years: according to various clinical and experimental studies, the disease depends on multiple factors and manifests itself with a neuropathic pain, that is, pain caused by a primary lesion or by a dysfunction of the nervous system. A pain that makes prevention complicated and painful, because vaginal visits and examinations cannot be tolerated, and which involves important expenses (between 20 and 100 thousand euros) to try to alleviate the suffering. Added to this are work problems, diagnostic errors and little consideration by doctors – and sometimes by family members – who end up attributing the symptoms to psychosomatic illnesses: a dangerous mix that contributes to triggering comorbidities of depression, already in itself linked to chronic pain symptoms, making pharmacological treatments and supplementary psychiatric therapies necessary. The high diffusion of the syndrome and the serious comorbidities that can be associated, therefore make vulvodynia a real social disease.

«The differential diagnosis of vulvodynia – explains the gynecologist Zaccaro – requires an accurate and expert clinical evaluation that excludes any pathology that could be responsible for symptoms similar to that given by vulvodynia, but with different origins such as infections, dermatoses and/or neoplasms . The absence of “apparent” visual alterations, associated with the limited knowledge of the syndrome by healthcare professionals, explains the severe diagnostic delayaggravated by the fact that many patients are classified as hypochondriacs or suffering from psychological or psychosomatic problems”.

How to book at the new Apulian clinic

The new clinic of the San Paolo hospital is accessible free of charge upon reservation, on Tuesdays and Thursdays from 11 to 13by contacting the following telephone number: 0805843669.

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