Vaginismus can be cured by new method developed by dr Vishwa Prakash

vaginismus is an condition in which ssex can not take place because of abnormal spasm of vaginal muscless

We for the first time developed a new technique to cure it  which ic published in american journal
You can reach to dr vishwa Prakash  at 9810115227
vpagarwal@gmail.com
drvishwaprakash.com

Read complete paper  below

SMGr up
How to cite this article Prakash V and Garg N. Intractable Vaginismus - Management by Incision of
Spasmodic Perivaginal Muscles and Resurfacing with Labia Minoraflaps - New Appraoch. SM Dermatolog J.
2017; 3(4): 1024.
SM Dermatology
Journal
OPEN ACCESS
ISSN: 2575-7792
Introduction
Vaginismus is defined according to DSM IV-TR as recurrent or persistent involuntary spasm
of the musculature of the lower third of the vagina, which interferes with sexual union and causes
matrimonial problems [1]. Inclusion of spasm in the definition has been questioned as it has not
been consistently documented [2]. It has been classified as primary when the woman has never
experienced non-painful penetrative sexual intercourse and as secondary when she has experienced
non-painful penetrative vaginal intercourse in the past [3]. Butrick has concluded that it is part of
hypertonic pelvic floor disorder [4]. Classical psychoanalytic theory conceptualized vaginismus as
a conversion disorder caused by unresolved psychosexual conflicts in early childhood. Vaginismic
women have been characterized as fixated or regressed to the pre-oedipal or oedipal stages [5].
Vaginismus is believed to be a psycho-physiologic disorder due to fear from actual or imagined
negative experiences with penetration. Women with vaginismus have also been noted to have lack
of sex education [5]. The condition has been treated by sex education [2], graded insertion of fingers
[6], Kegel’s exercises [7], use of local anesthesia [8], pharmacotherapy and botox injections [6].
However many a times the condition is not improved. In such patients we have used the newer
method of incision of spasmodic muscles with resurfacing with labia minora flaps successfully in
fourteen patients.
Material and Method
We have treated fourteen patients of age varying 18 to 28 years who have consulted various
gynaecologists and have tried various types of the treatments for vaginismus. All the patients never
had sexual intercourse. We tried to examine the patients which was not possible in any of the
patients and did the procedure as detailed below.
Technique
Patients were operated in general anaesthesia without muscle relaxation. The perivaginal
examination was done when severe grip on the examining finger was felt. The mucosa was incised
at rim at 8 and 4’O clock about 2 cm long extending from vaginal mucosa to vestibular mucosa
exposing the perivaginal muscles which were incised till constriction ring disappeared [Figures 1-5].
The incision of muscles should not be more than 50% thickness. The resulting defect was resurfaced
with labia minora flaps which have been detailed in literature [7]. After putting flaps the pervaginal
examination was done again to ascertain that there was no grip on examining finger. The vagina was
lightly packed.
Research Article
Intractable Vaginismus - Management
by Incision of Spasmodic Perivaginal
Muscles and Resurfacing with Labia
Minoraflaps - New Appraoch
Vishwa Prakash1* and Neeta Garg2
1Department of Plastic Surgery, Safdarjung Hospital, India
2Gynaecologist, Centre for Female Genital Reconstruction, Indirapurum, Ghaziabad, India
Article Information
Received date: May 30, 2017
Accepted date: Dec 22, 2017
Published date: Dec 29, 2017
*Corresponding author
Vishwa Prakash, Department of Plastic
Surgery, Safdarjung Hospital, New Delhi,
India, Tel: 09810115227;
Email: vpagarwal@gmail.com
Distributed under Creative Commons
CC-BY 4.0
Keywords Vaginismus; Labia minora
flaps; Pervaginal examination
Abstract
Introduction: Vaginismus is defined as recurrent or persistent involuntary spasm of the musculature of
the lower third of the vagina, which interferes with coitus resulting in matrimonial disharmony. There are many
methods described for the management of the condition. But most of times all methods fail to treat such patients.
We have developed a newer approach for management of this condition in which spasmodic muscles are incised
and resultant defect is resurfaced with Labia Minora Flaps.
Material and method: We have treated fourteen females who were married more than 5 years before and
had undergone all types of treatment without success.
Results: All of the females could initiate sexual intercourse within 3 weeks of surgery
Conclusion: Incision of spasmodic muscles and resurfacing with labia minora flaps is one of good option if
other treatment had failed, for management of vaginismus.
Citation: Prakash V and Garg N. Intractable Vaginismus - Management by Incision of
Spasmodic Perivaginal Muscles and Resurfacing with Labia Minoraflaps - New Appraoch.
SM Dermatolog J. 2017; 3(4): 1024. Page 2/3
SMGr up Copyright  Prakash V
Postoperatively the pack was removed next day which could be
done easily, which was a sign that there was improvement as initially
they were not allowing even examination. Further mould was given to
be worn for five minutes daily in morning and evening for six months
even if she was having regular intercourse.
Results
The results were good. All the girls could start sexual intercourse
after three weeks. Three of the patient had sexual intercourse and
became pregnant within six months.
Figure 1: Showing vaginal opening. Circular ring is demonstrated at vagina
orifice because of hypertonic perivaginal muscles.
Figure 2: Showing incision and exposure of muscles.
Figure 3: Showing raised labia minora muscles.
Figure 4: Resurfacing the defect by labia minora muscles.
Figure 5: Incision at 4’O clock.
Discussion
Vaginismus thought to be one of the most common female
psychosexual dysfunction but the exact prevalence rate among
general population is not known. Pacick PT in his paper stated that
approximately 1-7% of females worldwide suffer with this disease [8].
In sexual dysfunction clinics, the rate of disease varies from 5
to 17% [3]. Undoubtedly this condition can result in significant
interpersonal problems and marital discord.
Aetiology is thought to be unknown. Numerous papers note
a history of religious or strict sexual upbringing or aversion to
penetration because of perceived pain and bleeding with first time
intercourse. Sexual molestation may be more prevalent in this group
of patients.
It is hyper tonic disorder and is akin to hypertonic disorder of
limb. In most of the hypertonic limb disorder, the only treatment
which helps is surgery. Though we don’t have actual data but we
believe that there is focus of hyperactivity in vaginal muscles and
this should be interrupted in which healing should be primary as
secondary healing in the area may itself result in dyspareunia and
precipitation of the condition. By incising few fibres of circum vaginal
Citation: Prakash V and Garg N. Intractable Vaginismus - Management by Incision of
Spasmodic Perivaginal Muscles and Resurfacing with Labia Minoraflaps - New Appraoch.
SM Dermatolog J. 2017; 3(4): 1024. Page 3/3