Urinary excretion of oxalates, which causes burning and itching of the urethra, was proposed as a contributing factor based on a case report of symptom relief in a single patient whose symptoms were associated with hyperoxaluria and elevated urine pH (40). This etiologic theory was bolstered by the association of VVS and interstitial cystitis (41-43); both the vulvar vestibule and the urinary bladder are derived from the same embryologic cells and innervated by branches of the same nerves, suggesting the potential for a shared pathogenesis. However, a prospective study of low oxalate diets in 130 patients and 23 controls failed to confirm therapeutic efficacy (44).
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.