Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dys...Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.展开更多
Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are ofte...Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are often considered milder forms of cutting. Case Presentation: A 23-year-old Somali woman with FGM/C was referred for chronic clitoral pain and superficial dyspareunia after several inconclusive gynecological examinations. Her clitoris was found to be entrapped under the scar of the cut clitoral hood. We surgically lysed the scar and reconstructed a prepuce. At the two-month follow-up, the patient reported no pain and physiologic sexual response. Conclusion: Clitoral pain and dyspareunia after FGM/C can be due to the incarceration of the clitoral glans. Treatment is surgical lysis of the scar.展开更多
Background: The most common subtype of chronic vulvar pain is provoked vestibulodynia. The entry of the vagina is the site of acute and recurrent pain in this highly prevalent and debilitating condition, which is char...Background: The most common subtype of chronic vulvar pain is provoked vestibulodynia. The entry of the vagina is the site of acute and recurrent pain in this highly prevalent and debilitating condition, which is characterized by pressure application or attempted vaginal penetration. The aim of this study was to determine the effectiveness of topical spermidine in patients with vestibulodynia. Methods: Topical gels containing spermidine in hyaluronate complexes Ubi1 and Ubi2 endowed with differentiated release ratio and viscosity were applied at 3 doses/week during 4-weeks, then at 2 doses/week during the next 4-weeks in two groups of patients. Pain relief was measured by visual analogic score (VAS) and dyspareunia score expressed as percent improvement from baseline to posttreatment. Results: Group 1 treated with Ubi1 provided improvement in pain (46%) and dyspareunia (27%). However, the treatment in Group 2 resulted in a superior amelioration: VAS of pain (76%) and dyspareunia (50%) as Ubi2 gel provided higher dose and viscosity along with improved local application. Conclusions: Our results demonstrated that preparation 2 resulted in greater reduction in symptoms as compared to preparation 1 as measured by the VAS and Marinoff scale. These early, yet outstanding clinical outcomes in vestibulodynia through to the stimulation of tissue mechanosensor and their relevant downstream effects are reviewed hereafter.展开更多
Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male...Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male sexual or coital difficulties among couples attending the infertility clinic at BSUTH, Makurdi over a 2 year period. Methodology: This was a cross-sectional study involving all males attending the infertility clinic at Benue State University Teaching Hospital (BSUTH) who consent to participate in the study. A pretested structured questionnaire was administered and analyzed with statistical package for social sciences (version 23.0) and the results were presented in simple proportions. Results: There were several factors responsible for male coital difficulties. The most common was male erectile dysfunction 33 (32.4%), vaginismus 11 (10.8%), penile pain 14 (13.7%), poor response from the female partner 8 (7.8%) and severe dyspareunia 18 (17.1%). Conclusion: Coital difficulties resulting to low frequency of sexual exposure constitutes a major cause of infertility among males attending the infertility clinic at BSUTH, Makurdi. Therefore efforts should be made to evaluate these factors while assessing infertility couples in order to mitigate the effect.展开更多
Objective: To assess efficacy and tolerability of a new medical device in gel based on the synergic combination of NioskinTM Red Clover Extract noisome (NRC) and SylTechTM system (SB), a complex of silicium microcryst...Objective: To assess efficacy and tolerability of a new medical device in gel based on the synergic combination of NioskinTM Red Clover Extract noisome (NRC) and SylTechTM system (SB), a complex of silicium microcrystals covalently bound with silver ions associated with hyaluronic acid to the treatment of vulvo-vaginal dryness and dyspareunia in women taking combined oral contraceptive (COC). Methods: Forty eight women were treated for 12 weeks with NRC + SB vaginal gel (0.75 g/day) for 3 weeks. After therapy, symptoms (dyspareunia and dryness) were evaluated through a 10-cm VAS. Visual examination of the vagina and vulvar vestibule was also conducted, which included observations for petechiae, pallor, friability, dryness, and redness in the mucosa. Ratings were based on a 4-point scale (0, none;1, mild;2, moderate;3, severe). Results: NRC + SB vaginal gel appears to be effective for relief vulvo-vagianl dryness and dyspareunia and an improvement of vaginal and vestibular trophism was noted. Conclusion: NRC + SB vaginal gel proved good treatment options for relief of vulvovaginal symptoms in women who take COC.展开更多
Lichen sclerosus is a chronic and autoimmune dermatitis that develops in the anogenital region. It is related to genital alterations with repercussions in sexuality. We present a case of a 60-year-old woman who had se...Lichen sclerosus is a chronic and autoimmune dermatitis that develops in the anogenital region. It is related to genital alterations with repercussions in sexuality. We present a case of a 60-year-old woman who had several chronic diseases and had been diagnosed with vulvar lichen sclerosus for 20 years, with no response to multiple treatments (topical corticosteroids, immunomodulators). She was submitted to vulvectomy;however, it leads to worsening of her condition, presenting obliterated and fibrosed clitoris, atrophic vaginal lips, and anal and vulvar fissures. She remained with dyspareunia, decreased sexual desire and difficulty in orgasm. She underwent sexual therapy, adjustment of antidepressant medication and made intercalated use of topical corticosteroids, topical testosterone and vaginal moisturizers, with partial improvement. From this case we can conclude that, although vulvectomy can be related to some degree of improvement in patients with lichen sclerosus, serious complications can occur.展开更多
Application of vaginal mesh for stress urinary incon-tinence has seen widespread use due to its relatively short operative time in combination with its efficacy in treatment. However, vaginal mesh is not without its d...Application of vaginal mesh for stress urinary incon-tinence has seen widespread use due to its relatively short operative time in combination with its efficacy in treatment. However, vaginal mesh is not without its drawbacks and can lead to mesh erosion or extrusion, infection, dyspareunia, and recurrence of incontinence. Vaginal mesh complications can lead to feelings of hopelessness, isolation, shame, and emotional distress. Furthermore, failure to identify and address these complications in a timely manner can be permanently damaging to patient health. It is vital to be able to identify mesh complications early. Various imaging methodologies exist to visualize vaginal mesh placement and complications, including ultrasound, magnetic resonance imaging （MRI）, and computed tomography （CT）. This invited review paper focuses on the role of ultrasound in mesh visualization, mesh complication identification, and operative planning in the event of subsequent surgical mesh revision. Polypropylene mesh is echogenic on ultrasound, making it a useful tool for visualizing post-operative mesh placement. Transperineal, translabial and endovaginal ultrasound technique use has been described in the pre- and peri-operative setting to identify mesh in complex cases. Effcacy and practicality of CT and MRI use in identifying mesh in these cases is limited.展开更多
Importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which...Importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which makes any type of penetration (sexual, tampons, gynaecological examination tools) impossible. In this condition, a woman cannot control these muscle contractions and experiences moderate to intense pain. Objectives: To summarise published evidence on efficacy of physiotherapy for treating female sexual pain disorders, ways to evaluate the condition of a patient and to find the correct treatment. Evidence review: A literature search of Cochrane, PubMed, Journal of Sexual Medicine and Urogynecology Journal databases, SciELO, Google Scholar, Wiley Online Library and University of Barcelona Library was conducted. Findings: Physiotherapy techniques are used to strengthen pelvic floor muscles and relieve pain. Kegel exercises improve the symptoms of sexual pain disorders as they deal with weakened muscles. Vaginal cones exercises are used to strengthen the muscles by means of introduction of gradually increasing weights in the vagina. Biofeedback helps to increase muscle awareness and auto-evaluation of performed exercises. Thermotherapy relaxes muscles and increases elasticity of tissues which helps to reduce pain. Electro-stimulation improves the functionality of muscles. Myofascial therapy consists mainly in manual therapy and in liberating painful trigger points. Conclusions: The role of pelvic physiotherapy is to solve the problems related to sexual pain, recovering the pelvic floor by increasing muscle awareness and proprioception, improving muscle relaxation, toning the muscles and increasing the elasticity of the tissues in order to eliminate or reduce pain. Different exercise techniques, biofeedback, manual therapy and insertion techniques, as well as electro-stimulation and thermotherapy are used to achieve positive results.展开更多
目的研究手法按摩+低频电刺激+生物反馈在性交痛中的效果。方法选择2021年6月—2022年9月晋江市妇幼保健院收治的79例性交痛患者,以随机数字表法分为两组,研究组40例接受手法按摩+低频电刺激+生物反馈治疗,对照组39例实施低频电刺激+生...目的研究手法按摩+低频电刺激+生物反馈在性交痛中的效果。方法选择2021年6月—2022年9月晋江市妇幼保健院收治的79例性交痛患者,以随机数字表法分为两组,研究组40例接受手法按摩+低频电刺激+生物反馈治疗,对照组39例实施低频电刺激+生物反馈,治疗4周后评价总有效率,比较两组干预前后的性功能障碍评分、盆底肌力、尿流动力学指标、视觉模拟评分(visual analogue scale,VAS)、生活质量评分(quality of life,QOL),对比两组治疗结果。结果研究组总有效率为90.00%,高于对照组的71.79%(P<0.05)。两组干预前的性功能障碍评分差异无统计学意义(P>0.05);干预后研究组性生活质量、性欲望、总分均高出对照组(P<0.05)。两组干预前的盆底肌力差异无统计学意义(P>0.05);干预后研究组盆底肌力高于对照组(P<0.05)。两组干预前的VAS、QOL评分差异无统计学意义(P>0.05);干预后研究组VAS评分低于对照组,但QOL评分高于对照组(P<0.05)。两组干预前的尿流动力学指标差异无统计学意义(P>0.05);干预后研究组最大尿道压、腹压漏尿点压力、最大尿流率、最大尿道闭合压评分高于对照组(P<0.05)。结论手法按摩+低频电刺激+生物反馈的效果更为理想,能够缓解性功能障碍,改善盆底肌力及尿流动力学,快速降低疼痛,提高生活质量,值得推广。展开更多
文摘Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.
文摘Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are often considered milder forms of cutting. Case Presentation: A 23-year-old Somali woman with FGM/C was referred for chronic clitoral pain and superficial dyspareunia after several inconclusive gynecological examinations. Her clitoris was found to be entrapped under the scar of the cut clitoral hood. We surgically lysed the scar and reconstructed a prepuce. At the two-month follow-up, the patient reported no pain and physiologic sexual response. Conclusion: Clitoral pain and dyspareunia after FGM/C can be due to the incarceration of the clitoral glans. Treatment is surgical lysis of the scar.
文摘Background: The most common subtype of chronic vulvar pain is provoked vestibulodynia. The entry of the vagina is the site of acute and recurrent pain in this highly prevalent and debilitating condition, which is characterized by pressure application or attempted vaginal penetration. The aim of this study was to determine the effectiveness of topical spermidine in patients with vestibulodynia. Methods: Topical gels containing spermidine in hyaluronate complexes Ubi1 and Ubi2 endowed with differentiated release ratio and viscosity were applied at 3 doses/week during 4-weeks, then at 2 doses/week during the next 4-weeks in two groups of patients. Pain relief was measured by visual analogic score (VAS) and dyspareunia score expressed as percent improvement from baseline to posttreatment. Results: Group 1 treated with Ubi1 provided improvement in pain (46%) and dyspareunia (27%). However, the treatment in Group 2 resulted in a superior amelioration: VAS of pain (76%) and dyspareunia (50%) as Ubi2 gel provided higher dose and viscosity along with improved local application. Conclusions: Our results demonstrated that preparation 2 resulted in greater reduction in symptoms as compared to preparation 1 as measured by the VAS and Marinoff scale. These early, yet outstanding clinical outcomes in vestibulodynia through to the stimulation of tissue mechanosensor and their relevant downstream effects are reviewed hereafter.
文摘Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male sexual or coital difficulties among couples attending the infertility clinic at BSUTH, Makurdi over a 2 year period. Methodology: This was a cross-sectional study involving all males attending the infertility clinic at Benue State University Teaching Hospital (BSUTH) who consent to participate in the study. A pretested structured questionnaire was administered and analyzed with statistical package for social sciences (version 23.0) and the results were presented in simple proportions. Results: There were several factors responsible for male coital difficulties. The most common was male erectile dysfunction 33 (32.4%), vaginismus 11 (10.8%), penile pain 14 (13.7%), poor response from the female partner 8 (7.8%) and severe dyspareunia 18 (17.1%). Conclusion: Coital difficulties resulting to low frequency of sexual exposure constitutes a major cause of infertility among males attending the infertility clinic at BSUTH, Makurdi. Therefore efforts should be made to evaluate these factors while assessing infertility couples in order to mitigate the effect.
文摘Objective: To assess efficacy and tolerability of a new medical device in gel based on the synergic combination of NioskinTM Red Clover Extract noisome (NRC) and SylTechTM system (SB), a complex of silicium microcrystals covalently bound with silver ions associated with hyaluronic acid to the treatment of vulvo-vaginal dryness and dyspareunia in women taking combined oral contraceptive (COC). Methods: Forty eight women were treated for 12 weeks with NRC + SB vaginal gel (0.75 g/day) for 3 weeks. After therapy, symptoms (dyspareunia and dryness) were evaluated through a 10-cm VAS. Visual examination of the vagina and vulvar vestibule was also conducted, which included observations for petechiae, pallor, friability, dryness, and redness in the mucosa. Ratings were based on a 4-point scale (0, none;1, mild;2, moderate;3, severe). Results: NRC + SB vaginal gel appears to be effective for relief vulvo-vagianl dryness and dyspareunia and an improvement of vaginal and vestibular trophism was noted. Conclusion: NRC + SB vaginal gel proved good treatment options for relief of vulvovaginal symptoms in women who take COC.
文摘Lichen sclerosus is a chronic and autoimmune dermatitis that develops in the anogenital region. It is related to genital alterations with repercussions in sexuality. We present a case of a 60-year-old woman who had several chronic diseases and had been diagnosed with vulvar lichen sclerosus for 20 years, with no response to multiple treatments (topical corticosteroids, immunomodulators). She was submitted to vulvectomy;however, it leads to worsening of her condition, presenting obliterated and fibrosed clitoris, atrophic vaginal lips, and anal and vulvar fissures. She remained with dyspareunia, decreased sexual desire and difficulty in orgasm. She underwent sexual therapy, adjustment of antidepressant medication and made intercalated use of topical corticosteroids, topical testosterone and vaginal moisturizers, with partial improvement. From this case we can conclude that, although vulvectomy can be related to some degree of improvement in patients with lichen sclerosus, serious complications can occur.
文摘Application of vaginal mesh for stress urinary incon-tinence has seen widespread use due to its relatively short operative time in combination with its efficacy in treatment. However, vaginal mesh is not without its drawbacks and can lead to mesh erosion or extrusion, infection, dyspareunia, and recurrence of incontinence. Vaginal mesh complications can lead to feelings of hopelessness, isolation, shame, and emotional distress. Furthermore, failure to identify and address these complications in a timely manner can be permanently damaging to patient health. It is vital to be able to identify mesh complications early. Various imaging methodologies exist to visualize vaginal mesh placement and complications, including ultrasound, magnetic resonance imaging （MRI）, and computed tomography （CT）. This invited review paper focuses on the role of ultrasound in mesh visualization, mesh complication identification, and operative planning in the event of subsequent surgical mesh revision. Polypropylene mesh is echogenic on ultrasound, making it a useful tool for visualizing post-operative mesh placement. Transperineal, translabial and endovaginal ultrasound technique use has been described in the pre- and peri-operative setting to identify mesh in complex cases. Effcacy and practicality of CT and MRI use in identifying mesh in these cases is limited.
文摘Importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which makes any type of penetration (sexual, tampons, gynaecological examination tools) impossible. In this condition, a woman cannot control these muscle contractions and experiences moderate to intense pain. Objectives: To summarise published evidence on efficacy of physiotherapy for treating female sexual pain disorders, ways to evaluate the condition of a patient and to find the correct treatment. Evidence review: A literature search of Cochrane, PubMed, Journal of Sexual Medicine and Urogynecology Journal databases, SciELO, Google Scholar, Wiley Online Library and University of Barcelona Library was conducted. Findings: Physiotherapy techniques are used to strengthen pelvic floor muscles and relieve pain. Kegel exercises improve the symptoms of sexual pain disorders as they deal with weakened muscles. Vaginal cones exercises are used to strengthen the muscles by means of introduction of gradually increasing weights in the vagina. Biofeedback helps to increase muscle awareness and auto-evaluation of performed exercises. Thermotherapy relaxes muscles and increases elasticity of tissues which helps to reduce pain. Electro-stimulation improves the functionality of muscles. Myofascial therapy consists mainly in manual therapy and in liberating painful trigger points. Conclusions: The role of pelvic physiotherapy is to solve the problems related to sexual pain, recovering the pelvic floor by increasing muscle awareness and proprioception, improving muscle relaxation, toning the muscles and increasing the elasticity of the tissues in order to eliminate or reduce pain. Different exercise techniques, biofeedback, manual therapy and insertion techniques, as well as electro-stimulation and thermotherapy are used to achieve positive results.
文摘目的研究手法按摩+低频电刺激+生物反馈在性交痛中的效果。方法选择2021年6月—2022年9月晋江市妇幼保健院收治的79例性交痛患者,以随机数字表法分为两组,研究组40例接受手法按摩+低频电刺激+生物反馈治疗,对照组39例实施低频电刺激+生物反馈,治疗4周后评价总有效率,比较两组干预前后的性功能障碍评分、盆底肌力、尿流动力学指标、视觉模拟评分(visual analogue scale,VAS)、生活质量评分(quality of life,QOL),对比两组治疗结果。结果研究组总有效率为90.00%,高于对照组的71.79%(P<0.05)。两组干预前的性功能障碍评分差异无统计学意义(P>0.05);干预后研究组性生活质量、性欲望、总分均高出对照组(P<0.05)。两组干预前的盆底肌力差异无统计学意义(P>0.05);干预后研究组盆底肌力高于对照组(P<0.05)。两组干预前的VAS、QOL评分差异无统计学意义(P>0.05);干预后研究组VAS评分低于对照组,但QOL评分高于对照组(P<0.05)。两组干预前的尿流动力学指标差异无统计学意义(P>0.05);干预后研究组最大尿道压、腹压漏尿点压力、最大尿流率、最大尿道闭合压评分高于对照组(P<0.05)。结论手法按摩+低频电刺激+生物反馈的效果更为理想,能够缓解性功能障碍,改善盆底肌力及尿流动力学,快速降低疼痛,提高生活质量,值得推广。
