DYSPAREUNIA

DYSPAREUNIA= d term dyspareunia is loosely used for difficult as wel as painful coitus....CAUSES A) due to male partner =1-gross congenital abnormality of d penis...2-impotence usually partial..e.g. Failuse to maintain an erection long enough for penetration..3-premature ejaculation..4-complete n surprising ignorance in d technique of coitus..B)due to female partner= 1-painful lesions in d region of d introitur such as vulvitis..2-obstructive conditions at d vaginal introitus= rigid or imperforate hymen n painful carunculae myrtiformes, narrow introitus, traumatic stenosis..3=obstructive cond above d introitus-cogenital stenosis, acquired stenosis, benign n malignant tumours of vagina..4=uterine cond wich r nt obstructive bt b'coz they r painful, give rise to collision dyspareunia- cervicitis, chr parametritis n parametrial scars, adenomyosis uterus..5=extragenital lesions in d bowel, such as diverticulitis of sigmoid colon..

TREATMENT=deals wid cause..1= local abnormalities at d vulva can b cured by appropriate treatment,bt when dyspareunia is catsed by abnormalities hn d pouch of douglas an abdominal operation is necessary. 2=ovaries may b freed 4m adhesions, endometriosis n chocolate cysts can be excised n d uterus fixed in a postion of anteversion by an opertaion of ventrfsuspension..3= oestrogen cream is effective in a menopausal woman..4=psychogenic possibilties must b cnnsidered, pt enquiry may then elicit d true cause, such as fear pregnancy,frigidity, marital disharmony..