Chronic Idiopathic Mucocutaneous Pain Syndromes: Vulvodynia, Penodynia, and Scrotodynia

Chronic idiopathic vulvar pain (vulvodynia) occurs in up to 25% of women over the course of a lifetime. This pain may be associated with psychological, sexual, and social dysfunction. While the cause of vulvodynia is not known, moderation or clearing of the pain is possible with counseling, pelvic floor muscle rehabilitation through physical therapy, and medications used for other forms of neuropathic pain. Similar chronic idiopathic penile and/or scrotal pain (penodynia, scrotodynia) occurs in a much smaller proportion of men. Here too, there is often associated psychological, sexual, and social dysfunction. Counseling is usually unacceptable to these men, leaving only medication for neuropathic pain as potentially helpful therapy. It is the authors' perception that therapy for the clearance of pain is less successful in men than it is in women.