Journal of Psychosomatic Obstetrics and Gynecology (Oct 2017)

Women without vulvodynia can have a positive ‘Q-tip test’: a cross sectional study

  • Pedro Vieira-Baptista,
  • Joana Lima-Silva,
  • Jorge Beires,
  • Gilbert Donders

DOI
https://doi.org/10.1080/0167482X.2017.1327519
Journal volume & issue
Vol. 38, no. 4
pp. 256 – 259

Abstract

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Background: Vulvodynia is a frequently missed pathology, often confused with vaginismus. The Q-tip test (QTT) is fundamental for the diagnosis; however, there is lack of data about its performance in asymptomatic women. Objective: This study intended to evaluate the QTT for painful vestibular spots in asymptomatic women. Methods: Q-tips were gently pressed at different areas of the vulvar vestibule to obtain a 0–10 score representing the pain felt. This was performed in 267 consecutive patients presenting to the gynecology outpatient clinic for reasons other than vulvovaginal complaints. A questionnaire was done to evaluate the possibility of unrecognized vulvodynia. Results: Out of the 267 women, 18 (6.7%) fitted the diagnosis of vulvodynia and were excluded from the analysis. Of the remaining 249, 41 (16.5%) had a positive QTT. We could not find differences in the sexual activity rate between women with and without a positive QTT. No demographic differences could be found between the two groups. Only depression was more common in women with a positive QTT [31.7% (13/41) versus 10.8% (21/208), p=.001). Conclusions: Asymptomatic women can have painful vestibular spots in the absence of vulvodynia. A positive QTT cannot be considered equivalent to vulvodynia, highlighting the need for extensive workup of these women before that diagnosis can be assumed.

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