Dyspareunia in pelvic ring in women

BACKGROUND: Currently, researchers are interested in little-studied complications such as pain during intercourse, mainly in the pubic region, often combined with diastasis of the pubic symphysis. Our data and those of domestic and foreign authors presented the main problematic aspect, i.e., dysfunctions of the pubic symphysis. Literature data revealed the main reasons for the emergence of the above problems. The main complications of pelvic ring injuries, including sexual dysfunction in female patients, depending on the main causes, are considered.

OBJECTIVE: To improve the results of the treatment of the structural and functional disorders of pubic articulation in women.

MATERIALS AND METHODS: In the traumatology and orthopedic department No. 1 of the Priorov National Medical Research Center of Traumatology and Orthopedics (Moscow), 34 patients with pubic symphysis were examined. 26 (76.5%) patients underwent surgical treatment — metallodesis of the anterior pelvic half-ring with a plate, along with a defect plasty with osteoplastic biocomposite material for chronic postpartum ruptures and post-traumatic injuries of the pubic symphysis. The Majeed rating scale was used to determine sexual dysfunction and evaluate pelvic ring function.

RESULTS: Of 34 patients associated with chronic postpartum rupture or posttraumatic rupture of the pubic symphysis, 26 (76.5%) had sexual dysfunction; the time interval between natural childbirth and surgical treatment of the pelvic ring varied from 6 months to 10 years (mean 5.7 years), 12 (35.2%) patients developed moderate to severe accumulation symptoms from the lower urinary tract. 26 women underwent surgical intervention: metallodesis of the anterior pelvic half-ring which demonstrated the possibility of stopping dyspareunia.

CONCLUSION: Vertical or horizontal instability of the anterior pelvic ring leads to pelvic diaphragm failure in women, which in most cases causes dyspareunia.