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2003 ISSVD terminology and classification of vulvodynia: a historical perspective.

Vulvar pain occurring in the absence of an underlying recognizable disease has become an increasingly common clinical problem. Members of the International Society for the Study of Vulvovaginal Disease (ISSVD) astutely recognized this idiopathic vulvar pain as a unique entity in 1976 and, at that time, used the term burning vulva syndrome to identify it. Subsequently, the ISSVD renamed the disorder vulvodynia and suggested that two clinically distinctive subsets, dysesthetic vulvodynia and vestibulitis, might exist. However, recent studies have failed to confirm an inflammatory pathogenesis for vestibulitis, and in 1999 that term was deleted from the ISSVD classification. In 2003, at the 17th World Congress, the ISSVD reestablished vulvodynia as the preferred term for vulvar pain occurring in the absence of an underlying recognizable disease and, from a standpoint of classification, identified generalized and localized subsets. The ISSVD further noted that in either subset, pain could occur spontaneously and/or could develop as a result of physical provocation. The purpose of this recommended nosology is to further communication among the various specialties that care for women with vulvodynia and to assist in the formulation of studies regarding the pathophysiology and treatment of the disorder.