(242) INDOOR CYCLING AND PUDENDAL ENTRAPMENT NEUROPATHY: AN INCREASINGLY COMMON CAUSE OF VULVODYNIA

Most cases of Vulvodynia are mainly caused by Vulvitis-Vaginitis-STD-Allergies, but past year we´ve detected an increase in the Neurotraumatic etiology for young women practicing Spinnig. We analyze the incidence and causes in our population.

Retrospectively, 121 cases of Vulvodynia referred to our Clinic from Emergency, General Medicine and Internal Medicine (January'22 to January'23) were selected. Anthropometrics were: 49±6 years (21-59), weight 52±4Kg, height 159±9cm. 24 patients in this group performing indoor cycling (36±7 years, weight 47±5Kg, height 162±8cm) had been diagnosed with Pudendal Nerve Neuropathy. They presented perianal+vulvoperineal pain, vulvar hypoesthesias/paresthesias and diffuse genital discomfort modified with postural changes (pain when sitting, relief when standing up and disappearance when lying down). Due to Vegetative Nerve component, 18 women also reported urinary urgency.

Detailed Neurological examination was performed to identify the Sensitive nerve fascicles involved and a specific evaluation of exercise dynamics and bicycle/saddle design as causal factors.

After a joint Medicine-Physiotherapy-Psychology assessment, an integrated/individualized treatment was carried out for each case.

• 19 of 24 women had taken more than 6 months to be correctly diagnosed; 12 of them more than a year. All of them had visited more than one doctor.

• Most frequently affected Pudendal branches were Perineal Nerve (which affects the lower third of the Vagina/Urethra and Major/Minor labia) and Clitoris Dorsal Nerve.

• All examined bicycles had a rigid/hard seat.

• 17 women performed anterior vulvar compression against the bicycle seat.

• We are currently evaluating the impact of Vulvodynia on the sexual quality of life in female athletes.

1. Pudendal Neuropathy is an entity to take into account as cause of Vulvodynia

2. Often takes a few months to be correctly diagnosed

3. Mainly affects young athletic women

4. The hardness of the seats of the bicycles used in Spinning and the anterior vulvar compression position are the main causes of this disorder

Authors have no conflicts of interest.