Dyspareunia
Dyspareunia is pain with sexual intercourse and is not an uncommon complaints expressed by many of our female patients.
The actual cause is unknown but it appears to have a bi-modal age distribution between woman from 20-30 years of age and those who are 50-60 years old.
Common causes of dyspareunia found in the urological setting include:
- Atrophic vaginitis
- Urinary tract infection
- Interstitial cystitis
- Erosion of implantable mesh
- Tissue damage from radiation
- Organ prolapse
- Urethral abscess / vaginal cysts
- Sexual transmitted diseases
- Vaginismus
Workup includes a detail history and a thorough examination. Other evaluations may include:
- Urinalysis and urine culture
- Blood and vaginal swabs to screen for sexual transmitted diseases
- Cystourethroscopy
Treatment for Dyspareunia
Treatment for dyspareunia varies tremendously. If a direct cause of the pain is identified such as a urinary tract infection or a urethral abscess then treatment for the specific disorder will usually resolve the condition.
Otherwise, it may require a multimodality approach depending on the circumstances.
For women who are pre-menopausal, the solution maybe pelvic floor relaxation with the help of a physical therapist along with the use of water-based lubricants.
For others who are post-menopausal, the use of supplemental estrogen (if appropriate) along with the use of water-based lubricants has been proved effective.
If there is significant vaginal and/or pelvic organ prolapse then repair of this condition maybe indicated.
A more recent development for dyspareunia in women who suffers from atrophic vaginitis is the use of a CO2 laser therapy (MonaLisaTouch) to encourage regrowth of normal vaginal tissue. It is a simple and quick procedure that can be performed in the physician office.
