Bir Üniversite Hastanesinde Psikiyatri Polikliniğine Başvuran Vajinismus Hastalarının Retrospektif Analizi

Year 2019, , 569 - 572, 25.12.2019

Mehmet Asoğlu , Özlem Beginoğlu , Mustafa Demir , Hakim Çelik , Ülker Fedai , Öznur Akıl , Hamza Ayaydın , Fethiye Kılıçaslan

https://doi.org/10.35440/hutfd.657932

Abstract

Amaç: Bu çalışmada, vajinismus hastalarının sosyodemografik özelliklerini,
altta yatan etyolojik faktörleri ve grup terapisinin, vajinismus tedavisine
katkısını incelemeyi amaçladık.

Materyal ve
Metod: Bu çalışmaya, Aralık 2014
ile Ağustos 2016 tarihleri arasında Harran Üniversitesi Tıp Fakültesi
psikiyatri polikliniğine gelen ve vajinismus teşhisi konan 30 hasta dâhil
edilmiştir. Bu hastalar, ortalama 5 kişilik gruplar şeklinde, vajinismus grup
psikoterapisi alan hastalardan oluşturulmuştur. Hastaların dosyaları
retrospektif olarak incelenerek, sosyodemografik veriler elde edildi.
İstatistiksel analiz için Windows uyumlu IBM SPSS 23.0 (Chicago, ABD) paket
programı kullanıldı. Veriler, ortalama ± standart sapma (SD) olarak hesaplandı.

Bulgular: Çalışmaya dahil edilen hastaların ortalama yaşı 23,1 ± 4,02 bulundu.
Hastaların 8'i 20 yaş altı (% 26,7), 15'i 21-25 yaş (% 50), 7'si 26 yaş ve
üzeri (% 23,3) idi. En genç hasta 17, en yaşlısı 31 yaşında idi. Sadece iki
hastanın (% 6.7) çocuğu vardı. Hastaların tümü jinekolojik muayeneye gitmişlerdi
(%100). Çalışmamızda dış merkezde vajinismus terapisi gören ve tedaviyi yarım
bırakan 3 hasta bulunmaktadır (%10). Hastaların 18’i ilköğretim mezunu olup; ev
hanımıydı (%60). Geriye kalan 12 hasta ise üniversite mezunu olup; bir iş
yerinde çalışmaktaydı (%40). Çalışmamızdaki hastaların hepsi primer vajinismus
olup; daha önce hiç penis penetrasyonu olmamıştı (%100). Çalışmamızda ek bir
psikiyatrik hastalığı olan 4 kadın bulunmakta idi (%13,3). Hastaların üçünün
eşinde cinsel işlev bozukluğu mevcuttu (%10). Çalışmamıza dâhil edilen
hastaların ortalama evlilik süresi 8,8±9,3 ay olarak bulundu.

Sonuç: Vajinismus evliliğin birçok yönünü etkileyebileceğinden, bu cinsel
işlev bozukluğunun mümkün olduğu kadar erken tanı ve tedavisi büyük önem
taşımaktadır. Klinik gözlemlerimize göre, vajinismus grup psikoterapisi,
bireysel psikoterapiye göre belirgin bir şekilde hem daha kolay hem de çok daha
kısa sürede başarıya ulaşmıştır. Ayrıca zamanında teşhis ve etkin tedavi ile,
%100’e yakın bir oranda tedavi edilebilen bir hastalıktır.

Keywords

Vaginismus, Vaginismus group therapy

Retrospective Analysis of Vaginismus Patients Referred to Psychiatric Outpatient Clinic in a University Hospital

Abstract

Background: In this study, we have aimed to reveal the socio-demographic
characteristics of vaginismus patients and to determine the underlying causes.
In addition, we have also aimed to examine the contribution of group therapy to
vaginismus treatment.

Materials and Methods: The participants of this study consist of 30
patients who came to the outpatient psychiatry clinic of Harran University
Medical Faculty between December 2014 and August 2016 and who were diagnosed
with vaginismus. These patients were composed of patients who received
vaginismus group psychotherapy in groups of 5 people on average. Patients'
files were reviewed retrospectively and socio-demographic data were obtained.For
statistical analysis, a Windows-compatible IBM SPSS 23.0 (Chicago, USA) package
program was used. Dates were calculated as mean ± standard deviation (SD).

Results: The
mean age of the patients included in the study was found to be 23,1 ± 4,02.
Eight of the patients were younger than 20 years (26.7%), 15 were between 21-25
years (50%), and 7 were 26 years or older (23.3%). The youngest patient was 17
and the oldest was 31 years old.  Only
two patients had a child (6.7%). All patients underwent gynecological examination
(100%). In our study, there were 3 patients (10%) who received vaginismus
therapy in the external center and discontinued the treatment. Eighteen of the
patients were primary school graduates; housewife (60%). The remaining 12
patients were university graduates; (40%). All of the patients in our study
were primary vaginismus; never had penile penetration before (100%). In our
study, there were 4 women with an additional psychiatric disease (13.3%). Three
of the patients had sexual dysfunction in their husbands (10%). The mean
marriage duration of the patients included in our study was 8.8 ± 9.3 months.

Conclusion: Since vaginismus can affect many aspects of marriage, it is important
to diagnose and treat this sexual dysfunction as early as possible. According
to our clinical observations, vaginismus group psychotherapy has been
significantly easier and faster than individual psychotherapy. If diagnosis and
treatment are made in the time of vaginismus, we can help more patients to
overcome this kind of disease.

Keywords

Vaginismus, Vaginismus group therapy

References

• 1. Hawton K, Catalan J. Sex therapy for vaginismus. In: Characteristics for couples and treatment outcome. Sex Mar Ther. 5. 1990:39-48. 2. Laumann EO, Gagnon JH, Michael RT, Michael S. The social organization of sexuality, Sexual practices in the United States. 1994,Chicago, The University of Chicago. 3. Elke D, Reissing BA, Yıtzchack M, Khalife S. Does vaginismus exist? A critical review of the literature. The journal of Nervous and Mental Disease, 1999;187(5):261-274. 4. Simons JS, Carey MP. Prevalence of sexual dysfunctions. Results from a decade of research. Arch Sex Behav. 2001;30(2):177–219. 5. Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr, et all. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;(7):1598-607. 6. Oktay M, Tombul K. 200 cases of vaginismus: patients’ and their husbands’ psychological evaluation. New Symposium. 2003;(41):115-9. 7. Özdemir O, Simsek F, Özkardes S, İncesu C, Karakoç B. The unconsummated marriage: Its frequency and clinical characteristics in a sexual dysfunction clinic. J Sex Marital Ther. 2008;(34):268-279. 8. Kabakci E, Batur S. Who benefits from cognitive behavioural therapy for vaginismus? J Sex Marital Ther. 2003;(29):277-288. 9. Oniz A, Keskinoglu P, Bezircioglu I. The prevalence and causes of sexual problems among premenopausal Turkish women. J Sex Med. 2007;(4):1575-81. 10. Lewis RW, Fugl-Meyer KS, Bosch R, Fugl-Meyer AR, Laumann EO, Lizza E, et all. Epidemiology/risk factors of sexual dysfunction. J Sex Med. 2004;(1):35-9. 11. Silverstein JL. Origins of psychogenic vaginismus. Psychother Psychosom 1989; (52):197-204. 12. Kayir A, Sahin D. The role of spouses in the extension of vaginismus therapy. Archives of Neuropsychiatry 1997; (34): 178-85. 13. Masters WH, Johnson VE. editors. Human sexual inadequacy. Bantam Books 1st ed. New York. 1970: 244-6. 14. Dogan S, Dogan M. The frequency of sexual dysfunctions in male partners of women with vaginismus in a Turkish sample. Int J Impot Res 2008;(20):218-221. 15. Bachmann GA, Leiblum SR, Grill J. Brief sexual inquiry in gynaecologic practice. Obstet Gynec 1989; (23):425-427. 16. Tugrul C, Kabakci E. Vaginismus and its correlates. Sex Relat Ther. 1997;(12):23-34. 17.Tugrul C, Kabakci E. Predictor variables of vaginismus. Turk Psikiyatri Derg. 1996;(7):2017 18. Barnes J. Primary vaginismus (part 1). Social and clinical features (part 2). Etiological features. Ir Med J. 1986;(79):59-65 19. Crowley T, Richardson D, Goldmeier D. Recommendations for the management of vaginismus. BASHH Special Interest Group for Sexual Dysfunction. Int J STD AIDS. 2006;(17):14-8. 20. Goldstein, AT, Pukkal CF, Goldstein I. Female sexual pain disorders. Evaluation and Management. Garsington Road, Blackwell Publishing, 2009. 21. Yargıc I, Kayir A. Vaginismus: Presentation of a Group Psychotherapy. Düşünen Adam. 1996; 9(1):31-34. 22. Doğan and at.all. Trakya Univ medicine article 2009;26(2):151-158. 23. Mutlu EA. Comparisons of socio-demographic characteristics of patients diagnosed with vaginismus with sexual myth beliefs, sexual emotions, sexual satisfaction levels and peer evaluation forms. İnönü ünv. 2009;16-18 24. Berkol and et all. Bakırköy medical article. Medical Journal of Bakırköy. 2015;(11): 4. 25. Masters WH, Johnson VE, editors. Human sexual inadequacy. 1st ed. Bantam Books, New York,1970: 244-6. 26. Dogan S, Dogan M. The frequency of sexual dysfunctions in male partners of women with vaginismus in a Turkish sample. Int J Impot Res 2008;(20):218-221.