Zargooshi Javaad
Department of Urology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Sex Med. 2008 Dec;5(12):2895-903. doi: 10.1111/j.1743-6109.2008.01004.x.
Little research has been conducted about unconsummated marriage (UCM).
To report the long-term outcome of male sexual dysfunction (MSD) in UCM.
From 1997 to 2008, 417 couples presented to the author with UCM. The mean UCM duration ranged from 1 hour to 8 years. The median follow-up was 78.5 months.
Self-reported MSD in UCM based upon clinical history taking.
In 177 cases, UCM was due to erectile dysfunction (ED) (86), premature ejaculation (PE) (89), performance anxiety (25), vaginismus (34), hypodesire disorder (6), not knowing the coital technique (8), men who have sex with men (MSM) (2), hypogonadism (1), request by bride to delay coitus (1), and thick hymen (1) (more than one factor involved in many cases). In the remaining 240 cases, UCM was due to being under social pressure to have a quick intercourse while relatives waited behind the door to confirm and celebrate coitus by checking a handkerchief that was placed beneath the bride to become bloody by hymen perforation. Intracavernosal injection (ICI) using papaverine +/- phentholamine was used in 239 cases (57.3%); 221 (92.4%) responded. The eight cases who did not know the coital technique responded to sex education. Of the 50 men who were prescribed phosphodiesterase type 5 inhibitors, only 4 responded. Of the 26 men who received clomipramine (21) or fluoxetine (5) for PE, 2 and 1 responded, respectively. Fourteen grooms who did not respond to treatments later consummated spontaneously. No treatment was given to 94 grooms, including men with a diagnosis of psychotic disorder, men with learning difficulties, divorcing patients, and men in obligatory, loveless marriages. Ten untreated patients later consummated spontaneously. Of the 260 patients who consummated either with treatment (236) or spontaneously (24), 58 (22.3%) later presented with sexual complaints. The remaining 202 did well at a follow-up. Of the 157 couples who did not respond to treatment or did not receive treatment, 62 were either divorced or divorcing.
We strongly advise ICI as the first-line treatment of UCM. Oral therapies of ED and PE, vacuum constriction devices (VCD), and hymenectomy are of limited value. No treatment is indicated in many cases. Most grooms do well sexually in a long-term follow-up.
关于未完成性交的婚姻（UCM）的研究很少。
报告UCM中男性性功能障碍（MSD）的长期结果。
1997年至2008年，417对夫妇因UCM前来就诊。UCM的平均持续时间为1小时至8年。中位随访时间为78.5个月。
根据临床病史采集自我报告的UCM中的MSD。
在177例中，UCM的原因包括勃起功能障碍（ED）（86例）、早泄（PE）（89例）、性交焦虑（25例）、阴道痉挛（34例）、性欲减退障碍（6例）、不了解性交技巧（8例）、男男性行为者（MSM）（2例）、性腺功能减退（1例）、新娘要求推迟性交（1例）和处女膜过厚（1例）（许多病例涉及多个因素）。在其余240例中，UCM是由于社会压力要求快速性交，而亲戚们在门外等待，通过检查放在新娘下方的手帕是否因处女膜穿孔而染血来确认并庆祝性交。239例（57.3%）使用了罂粟碱+/-酚妥拉明进行海绵体内注射（ICI）；221例（92.4%）有反应。8例不了解性交技巧的患者对性教育有反应。在50例被开了5型磷酸二酯酶抑制剂的男性中，只有4例有反应。在26例因PE接受氯米帕明（21例）或氟西汀（5例）治疗 的男性中，分别有2例和1例有反应。14例对治疗无反应的新郎后来自然完成了性交。94例新郎未接受治疗，包括被诊断为精神障碍的男性、有学习困难的男性、正在离婚的患者以及处于强制无爱婚姻中的男性。10例未接受治疗的患者后来自然完成了性交。在260例通过治疗（236例）或自然方式（24例）完成性交的患者中，58例（22.3%）后来出现了性方面的抱怨。其余202例在随访中情况良好。在157对未对治疗有反应或未接受治疗的夫妇中，62对已经离婚或正在离婚。
我们强烈建议将ICI作为UCM的一线治疗方法。ED和PE的口服疗法、真空缩窄装置（VCD）和处女膜切除术价值有限。在许多情况下无需治疗。大多数新郎在长期随访中性功能良好。
