原發性陰道插入失敗的評估與治療
Evaluation and Management of Primary
Vaginal Penetration Failure. .
鄭丞傑
Liang HS;Jeng CJ;Yang YC;Chiang HS;Lee FK;Tzeng
CR
摘要 目的：找尋並分析原發性陰道插入失敗，導致性交未完成的原因，以及治療的模 式。材料和方法：由 212 對因為陰道插入困難，導致無法完成性交而至我們門診 的伴侶中，其中有 129 對完成了完整療程的評估及治療，並且有完整的追蹤及病 例可以查閱。診斷及治療是由：婦科醫師、泌尿科醫師、精神科醫師及性諮商人 員所組成的團隊所執行。我們將病因分門別類，並依據其個別原因進行治療。並 統計各種病因的比例，及治療的成效。結果：這 129 對性伴侶發生原發性陰道插 入失敗的原因可歸因於 6 類：陰道痙攣（佔 49%），不懂性知識及技巧（佔 31%）， 早洩或勃起困難，性恐懼或厭惡以及先天生殖道畸形。至於治療的成功率，各為： 93.3%、100%、83.3%、83.3%、75%及 100%。結論：第一：原發性陰道插入失 敗的原因最多的為陰道痙攣，以及缺乏性的資訊。此兩因素佔了絕大部分。第二： 前五個因素大多數是由心理障礙導致，經由團隊合作的治療，可以達到令人振奮 的成效。 AbstractObjective: To determine and analyze the etiologies and modalities of treatment for unconsummated coitus due to vaginal penetration failure. Material(s) and Method(s): This retrospective study investigated 212 couples, i.e., sexual partners, who visited our offices because of unconsummated coitus due to failure to penetrate the vagina, of them, 129 couples completed the full course of treatment and follow-up. A team consisting of a gynecologist, urologist, psychiatrist, and sex counselor was responsible for the diagnoses and treatments. We analyzed the individual causes and compared the results. Results: Primary vaginal penetration failures were divided into six categories of causes: vaginismus (49%), poor sexual knowledge or technique (31%),
premature ejaculation, erectile dysfunction, sexual aversion/phobia, and congenital abnormalities. The success rates of treatment were 93.3%, 100%,
83.3%, 83.3%, 75%, and 100%, respectively. Conclusion(s): Among the couples with unconsummated coitus, the two leading causes of vaginal penetration failure were found to be vaginismus and lack of sex information. Furthermore, most cases of vaginismus were due to psychological factors, which also contributed to vaginal penetration failure due to other causes. Thus, it was possible to resolve these underlined causes under the treatment
strategies recommended by the team.
