Lin Tangdi, Lou Wenjia, Fan Guorong, Niu Lina, Zhu Lan
Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Common Mechanism Research for Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Sex Med. 2025 Aug 11;13(4):qfaf057. doi: 10.1093/sexmed/qfaf057. eCollection 2025 Aug.
INTRODUCTION: Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a condition of persistent or recurrent, unwanted or intrusive sensation of genital arousal that is usually associated with a distressing feeling and has a great impact on patients' daily life. Pelvic floor physical therapy is one of the effective conservative treatment options that deserves increased attention. AIMS: This case report aims to provide a comprehensive pelvic floor physical therapy evaluation and treatment plans for a patient with PGAD/GPD that resulted in a complete resolution of symptoms. METHODS: The patient is a 63-year-old female who suffered from persistent and uncontrolled sexual arousal over 3 months. Despite her efforts, the symptoms gradually worsened and never completely resolved, resulting in significant distress and despair. Her examination findings include myofascial restrictions on superficial pelvic floor structures, hypertonic pelvic floor muscles with trigger points, radiating pain along with genitofemoral nerve innervated areas, and lack of pelvic floor muscle strength and coordination. Physical therapy treatment plan included patient education, manual therapy, muscle strengthening exercises, and home exercise programs. RESULTS: The patient's symptoms were completely resolved after a total of four pelvic floor physical therapy sessions. Home exercise program was able to maintain satisfactory treatment outcomes 3 months post treatment. No complaints were reported at the 6-month and 1-year follow-ups. CONCLUSION: Genitofemoral nerve pathology may be a potential etiology for PGAD/GPD. Pelvic floor physical therapy can an effective medical treatment for PGAD/GPD originating from the pelvic and perineum region. A comprehensive pelvic floor examination and an evidence-based treatment plan will be able to improve symptoms and potentially resolve them completely.
引言:持续性性唤起障碍/生殖器-骨盆感觉异常(PGAD/GPD)是一种持续或反复出现的、 unwanted或侵入性的生殖器唤起感觉,通常伴有痛苦的感觉,对患者的日常生活有很大影响。盆底物理治疗是一种有效的保守治疗选择,值得更多关注。 目的:本病例报告旨在为一名PGAD/GPD患者提供全面的盆底物理治疗评估和治疗计划,从而使症状完全缓解。 方法:患者为一名63岁女性,3个多月来一直遭受持续性且无法控制的性唤起。尽管她努力尝试,但症状逐渐恶化且从未完全缓解,导致严重的痛苦和绝望。她的检查结果包括盆底浅层结构的肌筋膜受限、伴有触发点的盆底肌肉张力亢进、沿生殖股神经支配区域的放射性疼痛,以及盆底肌肉力量和协调性不足。物理治疗计划包括患者教育、手法治疗、肌肉强化锻炼和家庭锻炼计划。 结果:总共进行了四次盆底物理治疗后,患者的症状完全缓解。家庭锻炼计划能够在治疗后三个月维持令人满意的治疗效果。在6个月和1年的随访中未报告任何不适。 结论:生殖股神经病变可能是PGAD/GPD的潜在病因。盆底物理治疗对于起源于骨盆和会阴区域的PGAD/GPD可能是一种有效的医学治疗方法。全面的盆底检查和基于证据的治疗计划将能够改善症状并有可能完全解决它们。
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