Yong Paul J, Sadownik Leslie, Brotto Lori A
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Multidisciplinary Vulvodynia Program, Vancouver General Hospital, Vancouver, BC, Canada; BC Women's Centre for Pelvic Pain and Endometriosis, BC Women's Hospital, Vancouver, BC, Canada.
J Sex Med. 2015 Jan;12(1):219-27. doi: 10.1111/jsm.12729. Epub 2014 Oct 27.
Little is known about women with concurrent diagnoses of deep dyspareunia and superficial dyspareunia.
The aim of this study was to determine the prevalence, associations, and outcome of women with concurrent deep-superficial dyspareunia.
This is a prospective study of a multidisciplinary vulvodynia program (n = 150; mean age 28.7 ± 6.4 years). Women with superficial dyspareunia due to provoked vestibulodynia were divided into two groups: those also having deep dyspareunia (i.e., concurrent deep-superficial dyspareunia) and those with only superficial dyspareunia due to provoked vestibulodynia. Demographics, dyspareunia-related factors, other pain conditions, and psychological variables at pretreatment were tested for an association with concurrent deep-superficial dyspareunia. Outcome in both groups was assessed to 6 months posttreatment.
Level of dyspareunia pain (0-10) and Female Sexual Distress Scale were the main outcome measures.
The prevalence of concurrent deep-superficial dyspareunia was 44% (66/150) among women with superficial dyspareunia due to provoked vestibulodynia. At pretreatment, on multiple logistic regression, concurrent deep-superficial dyspareunia was independently associated with a higher level of dyspareunia pain (odds ratio [OR] = 1.19 [1.01-1.39], P = 0.030), diagnosis of endometriosis (OR = 4.30 [1.16-15.90], P = 0.022), history of bladder problems (OR = 3.84 [1.37-10.76], P = 0.008), and more depression symptoms (OR = 1.07 [1.02-1.12], P = 0.007), with no difference in the Female Sexual Distress Scale. At 6 months posttreatment, women with concurrent deep-superficial dyspareunia improved in the level of dyspareunia pain and in the Female Sexual Distress Scale to the same degree as women with only superficial dyspareunia due to provoked vestibulodynia.
Concurrent deep-superficial dyspareunia is reported by almost half of women in a multidisciplinary vulvodynia program. In women with provoked vestibulodynia, concurrent deep-superficial dyspareunia may be related to endometriosis or interstitial cystitis, and is associated with depression and more severe dyspareunia symptoms. Standardized multidisciplinary care is effective for women with concurrent dyspareunia.
对于同时患有深部性交疼痛和浅表性交疼痛的女性，我们了解甚少。
本研究旨在确定同时患有深部 - 浅表性交疼痛的女性的患病率、相关因素及治疗结果。
这是一项对多学科外阴痛治疗项目（n = 150；平均年龄28.7 ± 6.4岁）的前瞻性研究。因激发性前庭炎导致浅表性交疼痛的女性被分为两组：同时患有深部性交疼痛（即同时患有深部 - 浅表性交疼痛）的女性和仅因激发性前庭炎患有浅表性交疼痛的女性。对治疗前的人口统计学特征、与性交疼痛相关的因素、其他疼痛状况及心理变量进行检测，以确定其与同时患有深部 - 浅表性交疼痛之间的关联。对两组患者治疗后6个月的情况进行评估。
性交疼痛程度（0 - 10分）和女性性困扰量表是主要观察指标。
在因激发性前庭炎导致浅表性交疼痛的女性中，同时患有深部 - 浅表性交疼痛的患病率为44%（66/150）。在治疗前，多元逻辑回归分析显示，同时患有深部 - 浅表性交疼痛与更高程度的性交疼痛独立相关（比值比[OR] = 1.19 [1.01 - 1.39]，P = 0.030）、子宫内膜异位症诊断（OR = 4.30 [1.16 - 15.90]，P = 0.022）、膀胱问题病史（OR = 3.84 [1.37 - 10.76]，P = 0.008）以及更多的抑郁症状（OR = 1.07 [1.02 - 1.12]，P = 0.007）相关，女性性困扰量表方面无差异。治疗后6个月，同时患有深部 - 浅表性交疼痛的女性在性交疼痛程度和女性性困扰量表方面的改善程度与仅因激发性前庭炎患有浅表性交疼痛的女性相同。
在多学科外阴痛治疗项目中，近一半女性报告同时患有深部 - 浅表性交疼痛。在因激发性前庭炎的女性中，同时患有深部 - 浅表性交疼痛可能与子宫内膜异位症或间质性膀胱炎有关，并与抑郁及更严重的性交疼痛症状相关。标准化的多学科护理对同时患有性交疼痛的女性有效。
