Examination of Treatment Duration, Treatment Success and Obstetric Results According to the Vaginismus Grades

Introduction: In patients with vaginismus, the treatment becomes more challenging and the treatment may take longer as the grade of vaginismus is higher or worsens. However, the differences regarding treatment duration, success, and treatment methods by grades are not evident in the literature. Aim: The aim of this study is to answer the question, "Does the number of treatment sessions, dilator require-ment, treatment success, pre-& post-treatment FSFI scores and obstetric results of vaginismus patients change depending on the vaginismus-grade?" Methods: The patients were divided into 4 grades according to the Lamont classification. They underwent step-wise treatment sessions by a single gynecologist. Treatment success, duration of treatment, mechanical dilator requirement, duration from marriage, pre-and post-treatment FSFI scores, pregnancy rates, and delivery types were compared between patients at different grades. Main Outcome Measures: Assessment of the differences between vaginismus-grades by comparing clinical observations and FSFI-scores. Results: Pain-free sexual intercourse occurred in 85 (93.4%) of 91 primary-vaginismus patients included in our study. The success rate was 100% in grade 1, 95.2% in grade 2, 92.1% in grade 3, and 92% in grade 4. Treat-ment session durations of the patients differed significantly by grades (P < .05). Same way the duration from marriage at the time of application differed significantly by the grade (P < .05). While there was a significant rela-tionship between vaginismus grade and dilator requirement, there was no significant relationship between vagi-nismus grade and delivery type (P < .05). 54.5% of 44 patients, who got pregnant, delivered by cesarean-section. There was a significant increase in FSFI scores in all groups in the pre-and post-treatment third month (P < ,05). Conclusion: Patients should be notified that as the grades of vaginismus progress, the duration of the treatment may extend, and its success may decrease, the requirement for mechanical dilators will increase in the advanced grade, and the grade may progress as the application period for treatment is delayed. Copyright (C) 2021 The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.