School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
J Sex Marital Ther. 2013;39(4):306-20. doi: 10.1080/0092623X.2012.697535. Epub 2013 Mar 7.
Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation.
盆底物理疗法用于治疗性疼痛障碍；然而，患有终身阴道痉挛的女性尚未被纳入治疗研究，也没有与获得性阴道痉挛和/或性交困难的女性区分开来。这项回顾性图表审查和访谈研究旨在获得从未有过阴道性交经历的女性的物理治疗干预、过程和结果的初步信息。连续在一家物理治疗诊所接受治疗的 53 名女性的档案被纳入图表审查；其中 13 名女性自愿接受采访。图表审查显示存在明显的盆底病理，平均治疗疗程为 29 次。内部手动技术被发现最有效，其次是患者教育、扩张练习和家庭练习。尽管参与者对物理治疗非常满意，但一些症状，如疼痛、焦虑/恐惧和盆底紧张仍然存在，女性性困扰量表和女性性功能指数的评分表明治疗后存在临床水平的性困扰和性功能障碍。尽管症状减轻与健康的性功能之间似乎没有线性关系，但这些初步信息表明，物理治疗可能是一些患有终身阴道痉挛的女性的有前途的治疗选择，值得进一步评估。
