Vaginismus Flashcards

1
Q

Definition

A

Psychologically conditioned relflex causing spasm of the pelvic floor musculature that prevents any attempt at vaginal entry

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2
Q

Aetiology

A
  • Sexual abuse
  • Painful first sexual encounter
  • Traumatic experience (Vaginal birth, STOP)
  • Associatd vulvodynia
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3
Q

Relevant history

A
  • Presents with avoidance of cervical smears, dyspaurenia or infertility
  • NB to see patient ALONE and with partner
  • Discuss previous tampon use and sexual intercourse
  • Depression screening
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4
Q

Examination

A

o Sensitive, reassuring approach – ensure patient aware than examination will cease if discomfort occurs, and speculum examination will not be attempted
o Assess external genitalia
o Cotton-tip test for vulvodynia
o Attempt insertion of single lubricated gloved finger
o Contraction of bulbocavernosum, pubococcygeus or puborectalis may be identified

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5
Q

Investigations

A

o Usually nil required
o Consider urine MCS, vaginal swab MCS to exclude contributing causes

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