Абстракт

Цели: Superficial dyspareunia is condition strongly affecting young girls due to many reasons: strong physical activities, stressful life and use of oral contraceptives mainly. More and more patients begin complaining of this issue which is strongly affecting their quality of life, also from the psychological point of view. Введение: A 24-year-old girl referred to our clinic in 2024 for important superficial dyspareunia strongly affecting her quality of life and relationships. She has been suffering from this issue since 2022. She was never able to have a healthy sexual life from that moment. At our first encounter she declared she had no complete penetrative intercourses for a year. At the visit she referred pain at the vaginal fourchette where some lesions (like post-menopausal women) were visible. She was visited by many other specialists, being strongly psychologically proven by the situation in the whole. Материалы / методы: We referred the patient to the pelvic floor rehabilitation centre, starting with biofeedback and penetrative cones. We then decided to inject biostimulants, without significative results. We for plasma rich in platelets (PRP) injections. Once again, without results. We opted for botulinum toxin A injection. Besides the elevator ani hypertonus, the real target was P protein downregulating nociception. She could have sexual intercourses with some pain. We opted at this point for radiofrequency on the fourchette, with three treatments. Every single time we evaluated the patient with FSFI score. Результаты: In June 2024 the patient reporting having a full penetrative intercourse without pain. Her FSFI levels from zero (no sexual intercourse) arrived at a maximum of 21. At the gynaecological visit some small lesions are still visible, probably due to second intention cicatrisation of tissues. Our clinical planning is to act on them with biostimulation and radiofrequency. Заключение: At the end we used a multimodal approach with this patient. We deeply think every patient need a tailored treatment and, such in this case, all alternatives may be examinated. Ad researchers, we actually do not know which of the many treatments she underwent was the resolving one. Most probably, the combination of botulinum toxin and radiofrequency, demonstrating once again the synergistic effect of multiple treatments, leading to success.