An unconsummated marriage: A case report

Vajinismus, penis, parmak, tampon veya spekulum penetrasyon girişimi halinde vajenin dış 1/3’ünü çevreleyen perineal kasların tekrarlayıcı veya persistan istemsiz kontraksiyonu olarak tanımlanır. Bu olgu sunumu, aile hekimliği polikliniğine başvuran ve Bilişsel Davranış Terapisi’nden (BDT) yarar gören vajinismuslu bir hastanın tedavi modelini ele almaktadır. Çift 19 aydır evliydi ancak cinsel birleşme sağlanamamıştı. Tanı DSM-IV kriterlerine göre kondu. Tedavi öncesi ve sonrasında çifte Golombok-Rust Inventory of Sexual Satisfaction (GRISS) endeksi uygulandı. İletişim, cinsel istek, erektil disfonksiyon, prematür ejekülasyon puanları ve toplam puan, erkekte de cinsel disfonksiyon olduğunu gösterdi. Tedavide, bilişsel yeniden yapılandırma teknikleri ile birlikte sensate focus ve kademeli duyarsızlaştırma (kendi kendine vajinal dilatasyon) yöntemleri kullanıldı. Kadının cinsel fonksiyonları iyileşme gösterdi.

Olgu sunumu: Tamamlanmamış bir evlilik

Vaginismus is described as “recurrent or persistent involuntary contraction of the perineal muscles surrounding the outer third of the vagina when vaginal penetration is attempted with penis, finger, tampon, or speculum. The purpose of this case report is to investigate the treatment model of a patient with vaginismus who benefited from Cognitive Behavioral Therapy (CBT) in a couple (woman 21, man 23 years old) admitting to family practice for treatment of vaginismus. The duration of marriage was 19 months. The marriage was unconsummated. The diagnosis was made using DSM-IV criteria. They have been assessed initially and after treatment by Golombok-Rust Inventory of Sexual Satisfaction (GRISS) index. The initial scores of communication, sensuality, erectile dysfunction and premature ejaculation and the total scores of the GRISS indicated accompanying sexual dysfunction in man. Sensate focus and gradual desensitization (vaginal self-dilatation) methods with cognitive restructuring techniques were used. The overall sexual functioning of the woman showed improvement.

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