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持续性生殖器觉醒障碍 - 现有知识。

Persistent genital arousal disorder - the present knowledge.

机构信息

Śląski Uniwersytet Medyczny w Katowicach, Wydział Nauk Medycznych w Zabrzu, Studenckie Koło Naukowe Psychiatrii.

Śląski Uniwersytet Medyczny w Katowicach, Wydział Nauk Medycznych w Zabrzu, Katedra i Oddział Kliniczny Psychiatrii w Tarnowskich Górach.

出版信息

Psychiatr Pol. 2022 Dec 31;56(6):1203-1219. doi: 10.12740/PP/OnlineFirst/135253.

Abstract

Persistent genital arousal disorder (PGAD) is a relatively recently described sexual disorder, characterized by symptoms of spontaneous genital arousal which persist in the absence of sexual desire and may affect women and men. Epidemiological studies conducted so far indicate that the prevalence of PGAD in the population may reach 1-4%. The etiology of PGAD remains unclear and complex, hypothesized causes include vascular, neurological, hormonal, psychological, pharmacologic, dietary, mechanical factors or a combination of these factors. Proposed methods of treatment include pharmacotherapy, psychotherapy, electroconvulsive therapy, hypnotherapy, injection of botulinum toxin, pelvic floor physical therapy, application of anesthetizing agents, reduction of identifiable factors exacerbating the symptoms, and transcutaneous electrical nerve stimulation. There is no standardized treatment algorithm for PGAD due to lack of clinical trials (evidence-based medicine). The classification of PGAD is under discussion: it could be classified as a separate sexual disorder, a subtype of vulvodynia or a disorder with pathogenesis similar to overactive bladder (OAB) and restless legs syndrome (RLS). Due to specificity of symptoms, patients may feel shame and discomfort during the examination or even delay reporting symptoms to the specialist. Thus, it is crucial to spread knowledge about this disorder, which would allow doctors to diagnose and help PGAD patients sooner.

摘要

持续性生殖器觉醒障碍(PGAD)是一种相对较新描述的性障碍,其特征是在没有性欲的情况下出现自发性生殖器觉醒症状,可能影响女性和男性。迄今为止进行的流行病学研究表明,PGAD 在人群中的患病率可能达到 1-4%。PGAD 的病因仍不清楚且复杂,假设的原因包括血管、神经、激素、心理、药物、饮食、机械因素或这些因素的组合。建议的治疗方法包括药物治疗、心理治疗、电惊厥治疗、催眠治疗、肉毒杆菌毒素注射、骨盆底物理治疗、应用麻醉剂、减少加重症状的可识别因素,以及经皮神经电刺激。由于缺乏临床试验(循证医学),因此没有针对 PGAD 的标准化治疗方案。PGAD 的分类正在讨论中:它可以归类为一种单独的性障碍、外阴痛的一种亚型,或一种与逼尿过度症(OAB)和不宁腿综合征(RLS)相似的发病机制的疾病。由于症状的特异性,患者在检查过程中可能会感到羞耻和不适,甚至会延迟向专家报告症状。因此,传播有关这种疾病的知识至关重要,这将使医生能够更早地诊断和帮助 PGAD 患者。

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