de Kruiff M E, ter Kuile M M, Weijenborg P T, van Lankveld J J
Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Centre, The Netherlands.
J Psychosom Obstet Gynaecol. 2000 Sep;21(3):149-55. doi: 10.3109/01674820009075622.
The purpose of this exploratory study was to identify clinical similarities and differences in patients with vaginismus and dyspareunia. Thirty patients who were referred to an outpatient clinic for psychosomatic gynecology and sexology, with either of these two diagnoses, were investigated by means of a standardized interview, physical examination and self-rating questionnaires. Based on the interview, no significant differences were demonstrated between patients with vaginismus and dyspareunia, in the ability to insert a finger into the vagina or to have a gynecological examination. No differences were found in the reported level of pain during coitus (or attempted coitus), inserting one finger into the vagina, or during gynecological examination. Patients with vaginismus, however, more often reported that coitus was impossible. The physical examination and self-rating questionnaires showed no differences at all between patients with vaginismus and dyspareunia in palpated vaginal muscular tension and reported anxiety or tension during the examination. Moreover, in both groups redness and painful areas on the vulva were equally common. Redness and pain on the same location were more frequently present in the dyspareunia group. Patients with dyspareunia reported higher levels of pain during the examination. In conclusion, neither the interview nor the physical examination produced useful criteria to distinguish vaginismus from dyspareunia. A multi-axial description of these syndromes is suggested, rather than viewing them as two separate disorders.
这项探索性研究的目的是确定阴道痉挛和性交疼痛患者的临床异同。30名因这两种诊断之一而被转介到身心妇科和性学门诊的患者，通过标准化访谈、体格检查和自评问卷进行了调查。根据访谈，阴道痉挛患者和性交疼痛患者在将手指插入阴道或进行妇科检查的能力方面没有显著差异。在性交（或尝试性交）、将一根手指插入阴道或妇科检查期间报告的疼痛程度方面也没有发现差异。然而，阴道痉挛患者更常报告性交是不可能的。体格检查和自评问卷显示，阴道痉挛患者和性交疼痛患者在触诊时的阴道肌肉紧张程度以及检查期间报告的焦虑或紧张程度方面没有任何差异。此外，两组中外阴发红和疼痛区域同样常见。同一部位的发红和疼痛在性交疼痛组中更频繁出现。性交疼痛患者在检查期间报告的疼痛程度更高。总之，无论是访谈还是体格检查，都没有产生区分阴道痉挛和性交疼痛的有用标准。建议对这些综合征进行多轴描述，而不是将它们视为两种单独的疾病。
