University of Health Sciences, Dr Lütfi Kırdar Kartal Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey.
University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey.
JBRA Assist Reprod. 2020 May 1;24(2):180-188. doi: 10.5935/1518-0557.20200018.
There are many predisposing factors associated with vaginismus, but there is lack of data in the literature regarding which and how of these factors influence the success rate of treatment. Our aim is to investigate the effects of factors that are considered as predisposing factors for vaginismus on treatment prognosis and success rate, with cognitive-behavioral therapy and desensitization exercises after sexual therapy.
Patients with vaginismus were divided into three groups. Group 1: patients who successfully completed vaginal penetration exercises after sexual therapy and experienced vaginal sexual intercourse; Group 2: patients who started penetration exercises but could not reach success; Group 3: patients who discontinued treatment before starting exercises. Demographic and sexual parameters were compared between the groups.
There were statistically significant differences between the groups in terms of history of vaginismus in relatives (4.3%, 23% and 35.7%, p=0.047, respectively), the unsuccessful therapy history (69%, 61% and 21.4%, p=0.014, respectively), and anal and/or oral sex ratios (47.8%, 7.7% and 57.1%, p=0.019, respectively). Mean number of sessions were significantly higher in patients saying, "It is my fault" than among those perceiving it as a common problem (10.6±2.9 ve 7.5±5.7, p=0.042, respectively), and in patients with sexual disorder in their male partners than those not having any problem (13.3±3.7 ve 8.2±3.7, p=0.013, respectively).
Patients are more resistant to treatment if they have a history of vaginismus among relatives or when one of the couple say, it is his or her fault.
阴道痉挛与许多诱发因素有关,但文献中缺乏关于这些因素中的哪些因素以及如何影响治疗成功率的数据。我们的目的是研究被认为是阴道痉挛诱发因素的因素对认知行为治疗和性治疗后脱敏练习的治疗预后和成功率的影响。
将阴道痉挛患者分为三组。第 1 组:经性治疗后成功完成阴道扩张运动并经历阴道性交的患者;第 2 组:开始进行扩张运动但未能成功的患者;第 3 组:在开始运动前停止治疗的患者。比较三组患者的人口统计学和性行为参数。
三组患者在亲属中阴道痉挛史(4.3%、23%和 35.7%,p=0.047)、治疗失败史(69%、61%和 21.4%,p=0.014)和肛交和/或口交比率(47.8%、7.7%和 57.1%,p=0.019)方面存在统计学差异。认为“这是我的错”的患者的平均疗程数明显高于认为这是共同问题的患者(10.6±2.9 与 7.5±5.7,p=0.042),而男性伴侣存在性功能障碍的患者比没有任何问题的患者的平均疗程数明显更多(13.3±3.7 与 8.2±3.7,p=0.013)。
如果患者亲属中有阴道痉挛史或夫妻一方认为这是他/她的错,患者对治疗的抵抗力就会更强。