Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the en...Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the endpoints of different etiologic pathways, although there is still little research addressing potential distinctions between these two groups, particularly with regard to sexuality. Aims: To compare sexual activity and behavior of women with provoked primary vestibulodynia (PVD1) and secondary vestibulodynia (PVD2) against age-matched controls. Methods: Fifty-seven participants (N = 57), mean age 25.72 (18-41) recruited from a gynecology clinic underwent a gynaecological examination and completed a self-report questionnaire: 20 (N = 20) were diagnosed with primary provoked vestibulodynia (PVD1), 19 (N = 19) with secondary provoked vestibulodynia (PVD2), and 18 (N = 18) were medically confirmed as no-pain controls. Main outcome: To verify any differences in the sexual behavior between primary, secondary vestibulodynias and controls. Results: Mean pain duration differed significantly in participants with PVD1 at 73.8 months against those with PVD2 at 37.4 months (p = 0.003). Frequency of sexual activity also differed significantly between the three groups (p = 0.012): the controls were at 27.8% against 0% in primary and secondary vestibulodynias for once or more a day. No significant difference was observed for the sexual arousal time and masturbation frequency. Vaginal penetration was overrepresented in controls (p 0.001) contrary to fellatio frequency (p = 0.016). Pain digital test was significantly different between the three groups in one finger (3.85 vs 0.08), two fingers (4.39 vs 0.06) or three fingers (5.39 vs 0.56) (PVD1 against controls), lubricated inserted fingers for pain verification (p 0.001). Conclusions: Provoked vestibulodynia generates problems in the sexual response and coital activity, this syndrome reflecting absence of pre-existing sexual problems, notably in the masturbatory activity and oral receptive female sex.展开更多
Seizures can lead to different injuries ranging from minor lacerations to serious head injuries or bony fractures. We report a rare case of a male patient presenting with a history of a distended abdomen and gross hem...Seizures can lead to different injuries ranging from minor lacerations to serious head injuries or bony fractures. We report a rare case of a male patient presenting with a history of a distended abdomen and gross hematuria following a seizure attack. After catheterization, the drained urine was bloodstained. On clinical suspicion of an acute abdomen, computed tomography was conducted, which showed intraperitoneal rupture of the bladder. At laparotomy, we found and repaired a laceration in the dome of the bladder in 3 layers. The postoperative period was uneventful. Our case shows that a complete abdominal examination is needed on patients following a generalized seizure episode. We also suggest that certain drugs for treating schizophrenia have anticholinergic effects, which may induce chronic urine retention. Chronic urine retention, especially in elderly male patients, may contribute to the risk of a spontaneous rupture of the bladder.展开更多
文摘Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the endpoints of different etiologic pathways, although there is still little research addressing potential distinctions between these two groups, particularly with regard to sexuality. Aims: To compare sexual activity and behavior of women with provoked primary vestibulodynia (PVD1) and secondary vestibulodynia (PVD2) against age-matched controls. Methods: Fifty-seven participants (N = 57), mean age 25.72 (18-41) recruited from a gynecology clinic underwent a gynaecological examination and completed a self-report questionnaire: 20 (N = 20) were diagnosed with primary provoked vestibulodynia (PVD1), 19 (N = 19) with secondary provoked vestibulodynia (PVD2), and 18 (N = 18) were medically confirmed as no-pain controls. Main outcome: To verify any differences in the sexual behavior between primary, secondary vestibulodynias and controls. Results: Mean pain duration differed significantly in participants with PVD1 at 73.8 months against those with PVD2 at 37.4 months (p = 0.003). Frequency of sexual activity also differed significantly between the three groups (p = 0.012): the controls were at 27.8% against 0% in primary and secondary vestibulodynias for once or more a day. No significant difference was observed for the sexual arousal time and masturbation frequency. Vaginal penetration was overrepresented in controls (p 0.001) contrary to fellatio frequency (p = 0.016). Pain digital test was significantly different between the three groups in one finger (3.85 vs 0.08), two fingers (4.39 vs 0.06) or three fingers (5.39 vs 0.56) (PVD1 against controls), lubricated inserted fingers for pain verification (p 0.001). Conclusions: Provoked vestibulodynia generates problems in the sexual response and coital activity, this syndrome reflecting absence of pre-existing sexual problems, notably in the masturbatory activity and oral receptive female sex.
文摘Seizures can lead to different injuries ranging from minor lacerations to serious head injuries or bony fractures. We report a rare case of a male patient presenting with a history of a distended abdomen and gross hematuria following a seizure attack. After catheterization, the drained urine was bloodstained. On clinical suspicion of an acute abdomen, computed tomography was conducted, which showed intraperitoneal rupture of the bladder. At laparotomy, we found and repaired a laceration in the dome of the bladder in 3 layers. The postoperative period was uneventful. Our case shows that a complete abdominal examination is needed on patients following a generalized seizure episode. We also suggest that certain drugs for treating schizophrenia have anticholinergic effects, which may induce chronic urine retention. Chronic urine retention, especially in elderly male patients, may contribute to the risk of a spontaneous rupture of the bladder.
