Advertisement

Pelvi-périnéologie

, Volume 4, Issue 2, pp 153–157 | Cite as

Les dyspareunies organiques

  • A. Bricou
  • D. Frimigacci
  • F. Demaria
  • R. Sakr
  • J. -L. Benifla
Pratique Médicale / Medical Practice

Résumé

Les dyspareunies concernent 4 à 28 % des femmes. On distingue les dyspareunies profondes et superficielles. L’interrogatoire et l’examen clinique doivent être minutieux pour ne pas ignorer une cause organique curable. La plainte de la patiente ne doit pas être négligée. Le diagnostic de dyspareunie d’origine psychogène ne doit pas être trop hâtif. Toutes les causes organiques doivent être identifiées et traitées spécifiquement au plus vite afin de limiter au maximum le retentissement psychologique. Nous exposons les principales causes de dyspareunies.

Mots clés

Dyspareunie superficielle Dyspareunie profonde Douleurs pelviennes chroniques 

Organic dyspareunia

Abstract

Dyspareunia affects 4 to 28% of women. There are two described types of dyspareunia: superficial and deep. The medical history and the physical examination must be thorough in order to find organic causes. Patients complaints must be taken seriously and psychological causes are only confirmed when all possible organic causes have been ruled out. Organic causes should be identified and treated immediately in order to limit psychological impact. We present in our study the more common causes of dyspareunia.

Keywords

Superficial dyspareunia Deep dyspareunia Chronic pelvic pain 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Références

  1. 1.
    Meana M, Binik YM, Khalife S, Cohen DR (1997) Biopsychosocial profile of women with dyspareunia. Obstet Gynecol 90:583–589PubMedCrossRefGoogle Scholar
  2. 2.
    Paniel BJ, Haddad B, Meneux E (1997) Les dyspareunies: approche gynécologique. In: La douleur en gynécologie. Arnette Blackwell Eds, pp. 271–280Google Scholar
  3. 3.
    Burrows LJ, Shaw HA, Goldstein AT (2008) The vulvar dermatoses. J Sex Med 5:276–283PubMedGoogle Scholar
  4. 4.
    Ejegård H, Ryding EL, Sjogren B (2008) Sexuality after delivery with episiotomy: a long-term follow-up. Gynecol Obstet Invest 66:1–7PubMedGoogle Scholar
  5. 5.
    Akotionga M, Traore O, Lakoande J, Kone B (2001) Séquelles génitales externes de l’excision au centre hospitalier national Yalgado: épidémiologie et traitement chirurgical. Gynecol Obstet Fertil 29:295–300PubMedCrossRefGoogle Scholar
  6. 6.
    Bruner D, Lanciano R, Keegan M, et al (1993) Vaginal stenosis and sexual function following intracavitary radiation for the treatment of cervical and endometrial carcinoma. Int J Radiat Oncol Biol Phys 27:825–830PubMedGoogle Scholar
  7. 7.
    Willhite LA, O’Connell MB (2001) Urogenital atrophy: prevention and treatment. Pharmacotherapy 21:464–480PubMedCrossRefGoogle Scholar
  8. 8.
    Paniel BJ, Haddad B, Medjadji M (1995) Dyspareunie orificielle: le point de vue du chirurgien. Contracept Fertil Sex 23:271–274PubMedGoogle Scholar
  9. 9.
    Harlow BL, Stewart EG (2003) A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? J Am Med Womens Assoc 58:82–88PubMedGoogle Scholar
  10. 10.
    Bornstein J, Maman M, Abramovici H (2001) “Primary” versus “secondary” vulvar vestibulitis: one disease, two variants. Am J Obstet Gynecol 184:28–31PubMedCrossRefGoogle Scholar
  11. 11.
    Friedrich EG Jr (1987) Vulvar vestibulitis syndrome. J Reprod Med 32:110–114PubMedGoogle Scholar
  12. 12.
    Shafik A, el-Sherif M, Youssef A, Olfat ES (1995) Surgical anatomy of the pudendal nerve and its clinical implications. Clin Anat 8:110–115PubMedCrossRefGoogle Scholar
  13. 13.
    Amarenco G, Lanoe Y, Perrigot M, Goudal H (1987) A new canal syndrome: compression of the pudendal nerve in Alcock’s canal or perinal paralysis of cyclists. Press Med 16:399Google Scholar
  14. 14.
    Ferrero S, Esposito F, Abbamonte LH, et al (2005) Quality of sex life in women with endometriosis and deep dyspareunia. Fertil Steril 83:573–579PubMedCrossRefGoogle Scholar
  15. 15.
    Fauconnier A, Chapron C, Dubuisson JB, et al (2002) Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril 78:719–726PubMedCrossRefGoogle Scholar
  16. 16.
    Ferrero S, Abbamonte LH, Giordano M, et al (2007) Deep dyspareunia and sex life after laparoscopic excision of endometriosis. Hum Reprod 22:1142–1148PubMedCrossRefGoogle Scholar
  17. 17.
    Abbott J, Hawe J, Hunter D, et al (2004) Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril 82:878–884PubMedCrossRefGoogle Scholar
  18. 18.
    Vercellini P, De Giorgi O, Mosconi P, et al (2002) Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. Fertil Steril 77:52–61PubMedCrossRefGoogle Scholar
  19. 19.
    Yeniel O, Cirpan T, Ulukus M, et al (2007) Adenomyosis: prevalence, risk factors, symptoms and clinical findings. Clin Exp Obstet Gynecol 34:163–167PubMedGoogle Scholar
  20. 20.
    Fauconnier A, Dubuisson JB, Foulot H, et al (2006) Mobile uterine retroversion is associated with dyspareunia and dysmenorrhea in an unselected population of women. Eur J Obstet Gynecol Reprod Biol 127:252–256PubMedCrossRefGoogle Scholar
  21. 21.
    Batioglu S, Zeyneloglu HB (2000) Laparoscopic plication and suspension of the round ligament for chronic pelvic pain and dyspareunia. J Am Assoc Gynecol Laparosc 7:547–551PubMedCrossRefGoogle Scholar
  22. 22.
    Allen WM, Masters WH (1955) Traumatic laceration of uterine support; the clinical syndrome and the operative treatment. Am J Obstet Gynecol 70:500–513PubMedGoogle Scholar
  23. 23.
    Serment H, Comiti J, Pissanciel G (1965) Syndrome de désinsertion utérine. Gynecol Obstet 64:271–282Google Scholar
  24. 24.
    Maher C, Baessler K, Glazener CM, et al (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18:CD004014Google Scholar
  25. 25.
    Guarnaccia MM, Rein MS (2001) Traditional surgical approaches to uterine fibroids: abdominal myomectomy and hysterectomy. Clin Obstet Gynecol 44:385–400PubMedCrossRefGoogle Scholar
  26. 26.
    Stovall DW (2001) Clinical symptomatology of uterine leiomyomas. Clin Obstet Gynecol 44:364–371PubMedCrossRefGoogle Scholar
  27. 27.
    Lippman SA, Warner M, Samuels S, et al (2003) Uterine fibroids and gynecologic pain symptoms in a population-based study. Fertil Steril 80:1488–1494PubMedCrossRefGoogle Scholar
  28. 28.
    Ferrero S, Abbamonte LH, Giordano M, et al (2006) Uterinemyomas, dyspareunia, and sexual function. Fertil Steril 86:1504–1510PubMedCrossRefGoogle Scholar

Copyright information

© Springer Paris 2009

Authors and Affiliations

  • A. Bricou
    • 1
  • D. Frimigacci
    • 1
  • F. Demaria
    • 1
  • R. Sakr
    • 1
  • J. -L. Benifla
    • 1
  1. 1.Service de gynécologiehôpital Armand-Trousseau (AP-HP)ParisFrance

Personalised recommendations