Jeng Cherng-Jye, Wang Lih-Rong
Department of Obstetrics and Gynecology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
J Sex Marital Ther. 2007 May-Jun;33(3):249-53. doi: 10.1080/00926230701267910.
Coital injury causing severe vaginal laceration is not uncommon during first coitus. However, hemorrhagic shock during consensual sexual intercourse is quite rare. In this report, there was one 30-year-old, 20-year-old one, and one 24 year-old women who suffered severe vaginal laceration and bleeding during the process of consensual coitarche. All subjects were transferred to the hospital in the condition of impending shock. We found that the lacerated sites were located at right posterior fornices in all cases. We postulate that these vulnerable sites of vaginal laceration may be due to the dextro-rotation characteristics of the uterus and the distensibility of the vagina in this area. The vaginal fornix can be extremely distended during sexual intercourse, making it vulnerable to laceration in this area. Besides, there was a disproportionate genital size in all three cases which may be a cause of vaginal laceration. It is critical that such patients receive a prompt diagnosis to provide efficient management. It needs only simple surgical skills to cure the injury if the vital signs are stable. However, those survivors may need further psychological consultation to prevent negative impact on their future sexual functioning.
初次性交时因性交损伤导致严重阴道撕裂并不罕见。然而，在双方自愿的性交过程中发生失血性休克却相当罕见。在本报告中，有一名30岁、一名20岁和一名24岁的女性在双方自愿的初次性交过程中发生了严重的阴道撕裂和出血。所有受试者均在休克即将发生的状态下被送往医院。我们发现所有病例的撕裂部位均位于右侧后穹窿。我们推测这些阴道撕裂的易伤部位可能是由于子宫的右旋特征以及该区域阴道的可扩张性。性交时阴道穹窿可极度扩张，使其在该区域易发生撕裂。此外，所有三例均存在生殖器大小不成比例的情况，这可能是阴道撕裂的一个原因。对于此类患者，及时诊断以提供有效的治疗至关重要。如果生命体征稳定，只需简单的手术技巧就能治愈损伤。然而，那些幸存者可能需要进一步的心理咨询，以防止对其未来性功能产生负面影响。
