Clinical Management of Vulvodynia by Alessandra Graziottin & Filippo Murina

Author:Alessandra Graziottin & Filippo Murina
Language: eng
Format: epub
Publisher: Springer Milan, Milano

The peripheral nociceptors are simple bare-ending nerve fibers that are wide-spread in the superficial layers of the skin. Nociceptors are classified as: Aδ, which are small-diameter, lightly myelinated, and C-fibres, which are not myelinated. Neurons originating at the nociceptors pass into the peripheral nerves and enter the spinal cord at the dermatomal level ascribed by their insertion. Innervation to the vulva is via the pudendal nerve which originates from the S2-4 nerve roots and the ilioinguinal and genitofemoral nerves, arising from L1-2. The latter two nerves are predominantly sensory, but the pudendal nerve contains motor, sensory, and sympathetic fibers which supply the complex autonomic reflexes of the pelvic organs. The vagina itself is relatively insensitive to pain, while the vulva and particularly the vulvar vestibule have a high level of free nerve endings.

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