El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objective: Systematic review and meta-analysis to assess the effects of uterine or paracervical lidocaine application on pain control during IUD insertion. Methods: PubMed and five other electronic research databases were searched through 15 November 2017 for RCTs comparing lidocaine treatment vs. a control (placebo or no-intervention) to prevent pain during IUD insertion. Searched terms included ‘IUD insertion’, ‘lidocaine’ and ‘randomised controlled trial’. RCTs evaluating lidocaine treatment before IUD insertion without restriction of language, age and IUD type. Pain measured by visual pain scales at tenaculum placement, IUD insertion and immediate post-IUD insertion. Results of random effects meta-analyses were reported as mean differences (MDs) of visual pain scale (VPS) scores and their 95% confidence intervals (CIs). Results: Eleven RCTs (n = 1458 women) reporting paracervical lidocaine block or uterine mucosa lidocaine application before IUD insertion. Lidocaine produced lower VPS scores during tenaculum placement (MD −0.99, 95% CI: −1.73 to −0.26), IUD insertion (MD −1.26, 95% CI: −2.23 to −0.29) and immediate post-IUD insertion period (MD −1.25, 95% CI: −2.17 to −0.33). Conclusion: Lidocaine treatment was associated with modest reduction of pain during tenaculum placement and after IUD insertion. / Revisión por pares

Introduction: Provoked vestibulodynia is a common life impacting disease. Research hasshown higher pain intensity and anxiety levels in primary (pain present since first penetrativeattempt) provoked vestibulodynia (PVD1) compared to secondary provoked vestibulodynia(PVD2) and mixed results regarding age and female sexual functioning when comparing thegroups.Aim: The aim of this study was to further investigate the differences between PVD1 andPVD2 regarding pain intensity, sexual functioning, age and anxiety levels. The secondary aimwas to analyze how PVD group, age, anxiety and pain intensity associates with sexualfunctioning.Method: A total of 57 women from the Netherlands and Sweden were recruited via socialmedia, advertisement and regional caregivers. This study was part of a larger study oncognitive behavioral group therapy for women with provoked vestibulodynia. Data wasextracted from a survey assessing intensity of pain, sexual functioning, age and anxiety levels.A t-test was used to compare the PVD1 and PVD2 groups and a multivariate regressionanalysis was used to analyze the variables association with sexual functioning.Results: No statistically significant differences were found regarding pain intensity, sexualfunctioning, age and anxiety levels between PVD1 and PVD2. Decreased sexual functioningwas significantly related to higher age and pain intensity.Conclusion: We found no significant differences between PVD1 and PVD2. Increased ageand higher pain intensity seems to associate with lower sexual functioning. Longitudinalstudies with a greater sample size are needed for further investigation.

Based on thirteen months of ethnographic fieldwork in a large research hospital in the U.S., this dissertation analyzes the experiences of eighty American women seeking relief for chronic genital pain. Through extended interviews with diagnosed women, and participant-observation in a vulvar speciality clinic, I investigate the barriers--linguistic, cultural and corporeal--faced by patients who must engender greater familiarity and comfort with their sexual and genital bodies in order to successfully recover from their symptoms. Written as a cultural analysis of the vulva, the dissertation examines the ambivalent relationships between female external genitalia, U.S. dominant culture, and an autonomous female sexuality. Attentive to the transgression, confusion and disorder evoked by the symptoms of vulvar pain, the dissertation redefines the clinical diagnostic phrase "other causes of genital discomfort" in sociolcultural terms. The concepts of "genital dis-ease" and "unwanted genital experience" are introduced and analyzed as corporeo-cultural phenomena that contribute to a profound sense of alienation between many diagnosed women and their genital bodies. In addition to an extended introduction and a description of both the clinical fieldsite and conditions under investigation, the dissertation uses four progressive chapters--Accumulation, Manifestation, Integration and Generation--to theorize the lived experience of vulvar pain. Through a critical dialogue with current clinical literature, through which vulvar pain is understood in increasingly physiological terms, the dissertation argues that an acknowledgment of collective and cultural genital "discomfort" must be included in the emerging diagnostic and treatment regimens for women with chronic and unexplained genital pain. / text

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