原發性陰道插入失敗的原因分析與治療效果

本研究的目的，在找尋并分析原發性陰道插入失敗，導致性交未完成的原因，以及治療的模式與效果。由202對因為陰道插入困難，導致無法完成性交而至我們們門診的性伴侶中，其中有129對完成了完整療程的評估及治療，并且有完整的追蹤及病歷可以查閱。診斷及治療是由：婦科醫師、泌尿科醫師、精神科醫師及性諮商人員所組成的團隊所執行。我們將病因分門別類，并依據其個別原因進行治療。并統計種種病因的比率，及治療的成并效。這129對性伴侶發生原發性陰道插入失敗的原因可歸因於6類：陰道痙攣（佔49%），不懂性知識及技巧（佔31%），早發性射精，勃起困難，性畏懼或厭惡以及先天生殖道畸形。至於治療的成功率，各為：93.3%、100%、83.3%、83.3%、75%及100%。除先天生殖道畸形，其餘五個因素大多數是由心理障礙導致，經由團隊合作的治療，可以達到令人振奮的治療成效。

關鍵字

未完成的性交；陰道插入；陰道痙攣；性功能障礙

並列摘要

The purpose of this study was to determine and analyze the etiologies and modalities of treatment for unconsummated coitus due to vaginal penetration failure. In this retrospective study, the researchers investigated 202 couples, i. e. , sexual partners who visited our clinic for the unconsummated coitus due to failure to penetrate the vagina betweenl99l and 2000. Among them, 129 couples completed the full course of treatment and follow-ups. A team consisting of a gynecologist, a urologist, a psychiatrist, and a sex counselor was responsible for the diagnoses and treatments. The individual causes were analyzed and the results were compared. The causes of primary vaginal penetration failure were divided into six categories: vaginismus (49%), poor sex knowledge or techniques (31%), premature ejaculation, erectile dysfunction, sexual aversion/phobia, and congenital abnormalities. The success rates of treatment were 93.3%, 100%, 83.3%, 83.3%, 75%, and 100%, respectively. Among the couples with unconsummated coitus, two leading causes of vaginal penetration failure were found, vaginismus and lack of sexual knowledge. Other causes were sexual aversion/phobia and male partner’s sexual dysfunction. Furthermore, most cases of vaginismus were due to psychosocial factors, which also contributed to other causes of vaginal penetration failure. Therefore, it was possible to resolve these underlined causes under the treatment strategies recommended and applied by the team workers.