Modesto Rey Novoa (a,b), Montserrat Muñoz-Sellart (b–d),
Marta Catalán Soriano (b,e) David Vinyes (b–d)

(a) Department of Obstetrics and Gynecology, Hospital Universitario de Burgos, Burgos, Spain
(b) Campus Docent de Sant Joan de Déu, Barcelona, Catalonia, Spain
(c) Neural Therapy Research Foundation, Barcelona, Catalonia, Spain
(d) Institute of Neural Therapy and Regulatory Medicine, Sabadell, Catalonia, Spain
(e) Department of Obstetrics and Gynecology, Hospital del Vendrell, Tarragona, Catalonia, Spain

Background: Localized vulvar pain (LVP) is a common condition among fertile women, with physical and psychosexual implications. Treatment is complex with limited benefits. Neural therapy is a regulatory therapy that uses injections of local anesthetics in low concentrations in specific points to treat different conditions.
Case Presentation: We present the cases of 5 women, ages 33–44 years, with LVP treated with procaine 0.5% injections in painful points. Complete relief from pain occurred in 2 patients, and significant improvement in 3. Only 1 or 2 sessions were required. Initial VAS score was ≥70 and decreased to ≤30 after the intervention. The improvement was maintained over time, with a minimum follow-up period of 6 months. None of the patients were able to have sex or use tampons due to pain, but they were able to resume after the intervention.
Conclusions: None of the treatments proposed up to now for LVP have shown to be effective in permanently improving the symptoms. The results of our case series of 5 patients with LVP suggest that local injection with procaine may be an option to consider, whether it is applied primarily or after insufficient standard procedures. Future randomized clinical trials could help elucidate the role of this intervention in LVP.

Vulvodynia · Vulvar pain · Vulvar vestibulitis · Local anesthetics · Procaine · Neural therapy