Dyspareunia Flashcards
1
Q
Etiology of superficial
A
1. Inflammatory: Atopic/contact dermatitis Other dermatological 2. Infections Vulvovaginitis HSV Interstitial vaginitis UTI 3. Mucosal dysfunction Irradiation Medications reducing lubrication->COCP, antiD Primary inadequate lubrication 4. Structural Imperforate Bartholins mass/abscess Vulvar dystrophies Perineal injury 5. Musculoskeletal Vagnismus 6. Other Psychosexual
2
Q
Etiology of deep
A
1. Infectiuos/inflammatory Endometriosis Pelvic infection 2. Structural Ovarian cysts or other ovarian lesions Adenomyosis Fibroids 3. MSK Levator ani sasm
3
Q
Define primary dyspareunia
A
Pain associated with intercourse since onset of sexual activity
4
Q
Secondary
A
Acquired over sexual lifetime
5
Q
Investigations
A
Depending on history 1. Vaginal sample for pH and "whiff" test->bacterial vaginosis, trichomonas, candida 2. Gonorrhea and chlamydia 3. HSV PCR 4. Urinalysis 5. Pelvic USS 6 Diagnostic laparoscopy 7. Cystoscopy->interstitial cystitis 8, Vulvovaginal biopsy for suspicious lesions
