Journal of Lower Genital Tract Disease最新文献

{"title":"A Mixed-Methods Study Examining Guideline-Concordant Colposcopy Practices Among a National Cohort of US Colposcopists.","authors":"Rebecca B Perkins, Lindsay Fuzzell, Naomi C Brownstein, Holly B Fontenot, Alexandra Michel, Marena Neggers, Paige Lake, Susan T Vadaparampil","doi":"10.1097/LGT.0000000000000876","DOIUrl":"10.1097/LGT.0000000000000876","url":null,"abstract":"<p><strong>Objectives: </strong>The 2017 ASCCP Colposcopy Standards guidelines were designed to maximize the diagnostic yield of colposcopy. However, guideline adoption is often slow, and few studies have examined management of patients undergoing colposcopy.</p><p><strong>Methods: </strong>To elucidate factors associated with utilization of the 2017 ASCCP Colposcopy Standards guidelines for patients undergoing colposcopic cervical biopsy, the authors cross-sectionally surveyed and interviewed physicians and advanced practice providers who perform colposcopy. Clinicians responded to a clinical vignette describing a common colposcopy scenario. Clinicians were asked to describe where they would biopsy and why. Binomial logistic regression models determined factors associated with guideline concordance. Qualitative interviews further explored practice patterns.</p><p><strong>Results: </strong>A total of 671 colposcopists participated from across the United States. A total of 541 (81%) participants reported colposcopy practice concordant with the 2017 ASCCP Colposcopy Standards guidelines. A total of 490 (73%) participants reported that they were using the 2017 ASCCP Colposcopy Standards guidelines. Male colposcopists and those who were internal and family medicine clinicians were less likely to report guideline-concordant management than females and obstetrician-gynecologists. Colposcopists discussed the rationale behind guideline-concordant aspects of care, including taking targeted biopsies and using excisional rather than ablation procedures.</p><p><strong>Conclusions: </strong>Most colposcopists perform biopsies and treatment consistent with the 2017 ASCCP Colposcopy Standards guidelines and understand the rationale behind multiple targeted biopsies.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"161-167"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Characteristics Associated With Adoption of Updated National Colposcopy Guidelines.","authors":"Lindsay Fuzzell, Naomi C Brownstein, Holly B Fontenot, Paige Lake, Alexandra Michel, Rebecca B Perkins, Susan T Vadaparampil","doi":"10.1097/LGT.0000000000000877","DOIUrl":"10.1097/LGT.0000000000000877","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adherence to the 2019 ASCCP risk-based management consensus guidelines for management of patients following colpscopic cervical biopsy among US colposcopists.</p><p><strong>Methods: </strong>To elucidate factors associated with utilization of the 2019 guidelines for patients undergoing colposcopic cervical biopsy, the authors cross-sectionally surveyed physicians and advanced practice professionals who perform colposcopy. Clinicians responded to clinical vignettes describing scenarios for which management recommendations differed between 2019 and prior management guidelines. Vignette 1 involved deferral of repeat colposcopy for patients with a low-risk biopsy, HPV, and cytology results. Vignette 2 involved deferral of excisional treatment on a patient with repeated low-grade biopsy results. Binomial logistic regression models determined factors associated with utilization of 2019 guidelines.</p><p><strong>Results: </strong>A total of 670 colposcopists participated from across the United States. For Vignettes 1 and 2, guideline-adherent responses were given by 30.5% and 66.1% of participants, respectively. Colpsocopists practicing in community health centers were more likely to perform guideline-concordant care for Vignettes 1 and 2. Hispanic compared to non-Hispanic colposcopists and Internal or Family medicine compared to OB-GYN colposcopists are less likely to perform guideline-concordant care in Vignette 2. Irrespective of their chosen response, most believed they were guideline-adherent.</p><p><strong>Conclusions: </strong>Many colposcopists may not realize their current management strategies are inconsistent with 2019 guidelines. Tailored education initiatives could address knowledge gaps, maximize patient benefits, and minimize harms.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"153-160"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Results of Extended Genotyping to Management of Positive Cervicovaginal Human Papillomavirus Test Results: Enduring Guidelines.","authors":"L Stewart Massad, Megan A Clarke, Rebecca B Perkins, Francisco Garcia, David Chelmow, Li C Cheung, Teresa M Darragh, Didem Egemen, Thomas S Lorey, Ritu Nayar, Morgan Newman, Carolann Risley, Robert A Smith, Nicolas Wentzensen","doi":"10.1097/LGT.0000000000000865","DOIUrl":"10.1097/LGT.0000000000000865","url":null,"abstract":"<p><strong>Objective: </strong>The Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee developed recommendations for the use of extended genotyping results in cervical cancer prevention programs.</p><p><strong>Methods: </strong>Risks of cervical intraepithelial neoplasia grade 3 or worse were calculated using data obtained with the Onclarity HPV Assay from large cohorts. Management recommendations were based on clinical action thresholds developed for the 2019 American Society for Colposcopy and Cervical Pathology Risk-Based Management Consensus Guidelines. Risk estimates were reviewed in relation to clinical action thresholds and used as the basis for draft recommendations. After an open comment period, recommendations were finalized and ratified through a vote by the Consensus Stakeholder Group.</p><p><strong>Results: </strong>Colposcopy is recommended after positive tests for human papillomavirus (HPV) types 16 and 18. For those positive for HPV 45, 33/58, 31, 52, 35/39/68, or 51 but negative for 16 or 18, triage with cytology or dual stain testing is recommended. When screening with primary HPV testing, for patients who test positive for HPV types 56/59/66 and no other carcinogenic types, repeat HPV testing in 1 year is recommended. When screening with cotesting, for those who test positive for HPV types 56/59/66 and no other carcinogenic types, 1-year return is recommended for negative for intraepithelial lesion or malignancy, atypical squamous cells of undetermined significance, and low-grade squamous intraepithelial lesion, and colposcopy is recommended for atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), atypical glandular cells, high-grade squamous intraepithelial lesion, or carcinoma. When patients without prior high-grade cytology (atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, atypical glandular cells, high-grade squamous intraepithelial lesion, or carcinoma) or histology (cervical intraepithelial neoplasia [CIN]2, CIN3, or adenocarcinoma in situ) are being followed, use of extended genotyping results is acceptable. When high-grade cytology or histology results are present, or when patients are being followed after treatment of CIN2+, management using the 2019 guidelines is recommended.</p><p><strong>Conclusions: </strong>Human papillomavirus extended genotyping can guide clinical management in the setting of a positive HPV test result.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"134-143"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Guidelines on Anal Cancer Screening: A Systematic Review.","authors":"Andreia Albuquerque, Filipa Fontes","doi":"10.1097/LGT.0000000000000878","DOIUrl":"10.1097/LGT.0000000000000878","url":null,"abstract":"<p><strong>Objectives: </strong>Reports have recently been published on the risk stratification of anal squamous cell carcinoma (SCC) in several populations and the benefits of treating precancerous anal lesions to reduce the risk of progression to anal SCC. These studies have led several societies to publish new recommendations for anal cancer screening. This study systematically reviews anal cancer screening recommendations across different societies and institutes published after the ANCHOR trial.</p><p><strong>Methods: </strong>The authors systematically reviewed society recommendations for anal cancer screening that have been published since July 2022.</p><p><strong>Results: </strong>This study included 6 publications: 3 societies made recommendations only for individuals living with HIV, and 3 made recommendations for other high-risk groups, such as women with vulvar cancer/high-grade squamous intraepithelial lesions (HSILs) and female transplant recipients. Four societies recommended anal cytology, with or without human papillomavirus (HPV) testing, as the first screening method. One society recommended anal cytology, HPV testing, or cotesting as possible options, while 1 suggested HPV type 16 testing. Only 1 society has made recommendations on screening discontinuation. High-resolution anoscopy was recommended during follow-ups for individuals with abnormal results, although the referral threshold varied between societies according to the screening method results. All societies that mentioned anal HSIL treatment recommended it. Four societies expanded their recommendations beyond screening and treatment to include smoking cessation and/or HPV vaccination.</p><p><strong>Conclusions: </strong>Currently, there are several recommendations for anal cancer screening that include target groups, screening methods, treatment, follow-up, and other anal SCC prevention methods.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"180-185"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostatic Efficacy of TachoSil in Loop Electrosurgical Excisional Procedure: A Prospective Randomized Controlled Study.","authors":"Junhwan Kim, Jeong-Yeol Park","doi":"10.1097/LGT.0000000000000867","DOIUrl":"10.1097/LGT.0000000000000867","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to evaluate the hemostatic efficacy of the fibrin sealant patch (TachoSil) after loop electrosurgical excision (LEEP) and its influence on other complications and quality of life (QoL).</p><p><strong>Materials and methods: </strong>This single-blind, prospective, randomized study involved patients undergoing LEEP with or without TachoSil (1:1) between August 2014 and August 2015 in Asan Medical Center, Korea. Primary outcome measures were bleeding duration and the frequency of additional treatment owing to vaginal bleeding within 2 weeks after LEEP. Secondary outcome measures were vaginal bleeding volume using pictorial blood loss assessment chart (PBAC) score, the amount of vaginal discharge, the frequency of external genitalia, vaginal, and cervical infections within 2 weeks after LEEP, and changes in QoL.</p><p><strong>Results: </strong>Of the 140 patients enrolled, 126 (90.0%) were successfully followed up and analyzed. The median vaginal bleeding duration and frequency of additional treatment owing to vaginal bleeding showed no significant difference in the TachoSil applied and nonapplied groups ( p = .96 and p = .61, respectively). In addition, no significant difference was also observed in vaginal bleeding volume between 2 groups ( p = .64). In subgroup analysis for patients who underwent large LEEP (the longest dimension of ≥2 cm), significant improvement was observed at physical functioning in QoL at 2-3 ( p = .03) and 6 weeks ( p = .03) after LEEP of the TachoSil applied group, compared to the nonapplied group.</p><p><strong>Conclusions: </strong>TachoSil did not demonstrate significant hemostatic efficacy after LEEP. However, TachoSil improved patient recognition on physical function in patients who underwent large LEEP.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"123-130"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of the Vulvar Disease Literature With Images of Women of Color.","authors":"Gabriela Ashenafi, Ulrike C Dehaeck, Nina A Madnani, Ebony C Parker-Featherstone, Natalie A Saunders, Kathryn C Welch, Arshpreet Kaur Mallhi, Hope K Haefner","doi":"10.1097/LGT.0000000000000869","DOIUrl":"10.1097/LGT.0000000000000869","url":null,"abstract":"<p><strong>Objective: </strong>To assess the existing literature on vulvar disease in women of color (WOC).</p><p><strong>Methods: </strong>A narrative review was conducted to assess the literature on vulvar disease in WOC and evaluate the presence of images in this population. The search encompassed PubMed and OVID using relevant terms related to vulvar conditions and various groups of WOC. Case reports, as well as posters were excluded. Books on this topic were searched using these two search engines and Google, as well as the Taubman Health Sciences Library at the University of Michigan. This library contains numerous books on vulvar diseases commonly used by health care providers.</p><p><strong>Results: </strong>This query identified 24 journal publications on vulvar diseases in WOC. Twenty-six books, commonly used by health care providers, were found to have been published with vulvar images of WOC. However, only 1 focused specifically on vulvar diseases in WOC.</p><p><strong>Conclusions: </strong>There is a notable scarcity of articles and books addressing vulvar conditions specifically in WOC. This gap in literature limits the understanding of how these conditions may uniquely affect this demographic population. Additional research and resources are essential to effectively represent and meet the health needs of WOC.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"201-203"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triage Value of Cervical Exfoliated Cell DNA Ploidy Analysis in Cervical High-Risk Human Papillomavirus-Positive Women: Erratum.","authors":"Boliang Chu, Jie Dong, Yingying Chen, Xiaofang Ru, Wenwen Zhang, Yun Chen, Xiaoxing Zhang, Xiaodong Cheng","doi":"10.1097/LGT.0000000000000889","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000889","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis to Excision: Estimates for Guideline-Concordant Treatment of High-Grade Cervical Intraepithelial Neoplasia.","authors":"Nerlyne Desravines, Michael R Desjardins, J Stuart Ferriss, Jamie Perrin, Lisa Rahangdale","doi":"10.1097/LGT.0000000000000880","DOIUrl":"10.1097/LGT.0000000000000880","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the proportion of participants with high-grade cervical intraepithelial neoplasia (CIN 2/3) who completed indicated therapeutic procedures.</p><p><strong>Methods: </strong>This was a retrospective observational cohort study of the National Institutes of Health's All of Us database enriched for racial and ethnic minorities historically underrepresented in biomedical research. We included female participants aged 25 and older with a diagnosis of CIN 2/3 only, excluding invasive malignancy. We conducted both univariate and multivariate logistic regression to identify background characteristics associated with guideline-concordant ablative and excisional procedures.</p><p><strong>Results: </strong>Of 1,764 participants with CIN 2/3, only 27.7% of participants underwent a therapeutic procedure in the 12 months following a diagnosis of CIN 2/3. We found that Hispanic participants had a 1.48 increased odds ratio (OR) (95% CI = 1.18-1.85) of undergoing therapeutic procedures (compared to non-Hispanic). Participants residing in the Midwest had a 2.04 OR (95% CI = 1.6-2.6) of undergoing a therapeutic procedure compared to the Northeast. After adjusting for race, ethnicity, region, and smoking status, Hispanic ethnicity remained associated with therapeutic excision (OR = 2.37, 1.13-4.78). Geography was significant with 2.37 (95% CI = 1.17-3.29) increased odds of therapy completions for Midwest residents but 0.52 (95% CI = 0.27-0.96) decreased odds for Western residents.</p><p><strong>Conclusion: </strong>In this large US national database enriched for racial and ethnic minorities, we found that 3 of 4 participants with cervical precancer did not undergo a therapeutic procedure in the 12 months following their first diagnosis. Increased efforts to promote access to and completion of treatment of CIN 2/3 are needed to prevent cancer.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional Study on the Detection of HPV Infections for Cervical Cancer Screening Using a Self-Sampling Device.","authors":"Marta Arnáez de la Cruz, Anna Martin Marti, Stela Álvarez Fernandez, Marta Gurrea Soteras, Maria Dolores Comes García, Heidi Mauricio Aviñó, Julia Haba Moya, Santiago Domingo Del Pozo, Mireya Prieto Rodríguez","doi":"10.1097/LGT.0000000000000884","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000884","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates a new vaginal self-sampling device for high-risk human papillomavirus (HR-HPV) detection compared to clinician-collected samples using real-time polymerase chain reaction (PCR).</p><p><strong>Methods: </strong>A total of 345 women aged between 23 and 72 were enrolled in this study. After receiving information about the study, women were provided with a vaginal collecting device to collect self-sample, and then a medical professional collected the cervical sample. All the clinician-collected samples were processed using the Cobas 4800 HPV assay, and the self-samples were processed with the automated MAIS extraction system. These results were used to compare the new device's performance to the clinician-collected cervical samples. All the clinician-collected samples were also analyzed with a new HPV screening assay to compare the performance of this assay on 2 different types of samples.</p><p><strong>Results: </strong>Overall agreement for detecting any HR-HPV between clinician-collected samples and self-samples was 93.7% with a Cohen κ coefficient of 0.842. As both assays allow to identify genotypes 16, 18 and to detect the same 12 HR-HPV genotypes in a pool, we analyzed the agreement between self- and clinician-collected samples by genotypes and it was shown to be also excellent for HPV16 and the pool of other HR-HPV.</p><p><strong>Conclusions: </strong>This self-sampling device has demonstrated detection rates that are comparable to those of samples collected by clinicians.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotherapy and Psychotherapeutic Techniques for the Treatment of Vulvodynia: A Systematic Review and Meta-Analysis.","authors":"Janice F Queiroz, Ayane C A Sarmento, Antonio C Q Aquino, Amaxsell Thiago Barros de Souza, Kleyton Santos de Medeiros, Megan L Falsetta, Ana Katherine Gonçalves","doi":"10.1097/LGT.0000000000000881","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000881","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of psychotherapy and psychotherapeutic techniques for reduction of vulvar pain and the improvement of sexual function and psychological adjustment in vulvodynia.</p><p><strong>Material and methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, PsycInfo, and Clinical Trial Databases were searched on July 19, 2024. We included randomized controlled trials comparing psychotherapy interventions and psychotherapeutic techniques for vulvodynia. The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. RevMan 5.4 was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to assess the strength of the evidence.</p><p><strong>Results: </strong>A total of 1,884 articles were retrieved. Eight studies met the eligibility criteria and were included in the systematic review, comprising 689 participants. Two studies were included in the meta-analysis, these with 143 participants. When comparing the Acceptance and Commitment Therapy (ACT) with the control group, the mean difference (MD) in the pooled analysis for the Chronic Pain Acceptance Questionnaire did not differ significantly between ACT therapy and other therapies for posttreatment assessment (MD = 0.77; 95% CI = 3.45-4.99). Only 1 study was at high risk of bias due to a lack of clarity about the outcome measurement process. The GRADE rating for the certainty of the evidence for vulvar pain acceptance using ACT was considered low.</p><p><strong>Conclusions: </strong>Psychotherapy significantly improves vulvar pain, psychological adjustment, and sexual function in women with vulvodynia. Additionally, our meta-analysis showed that ACT and other psychotherapeutic interventions improve psychological adjustment through pain acceptance. However, more rigorous studies are needed to improve the quality of evidence and inform clinical practice.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}