ArticleInternational journal of women's health2026
Managing Vaginismus with Assisted Dilatation Multidisciplinary Protocol - Retrospective Cohort Study from Indonesia's Largest Dedicated Centre.
Article in International journal of women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Vaginismus is a gynecologic disorder with persistent vaginal spasm whenever any penetration is attempted. This leads to a failure of penetration. Vaginismus' true prevalence is unknown and reporting heavily biased. A similar condition is happening in Indonesia, where our facility treats >200 new cases/year. No standardized vaginismus treatment protocol is available internationally, so this retrospective study evaluates our multidisciplinary assisted dilatation protocol and the obstetric outcomes of our patients. Methods: This is a retrospective cohort study of all patients presenting with vaginismus undergoing assisted dilatation between 01/01/2022 and 31/12/2023. Diagnosis is through the presence of vaginal muscle spasms precluding penetration and/or severe penetrative pain, as confirmed by history and physical examination. We included all patients undergoing assisted dilatation in this timeframe. We employed a standardised multidisciplinary approach involving gynaecologist, psychiatrist and specialist nurses. It combines botulinum toxin A injections, dilator exercises and psychiatric medications. Patients are followed up 6-8 weeks post-dilatation and their obstetric outcomes are recorded through an online questionnaire. Results: We included 513 patients. 85.4% (438/513) presented due to failure of penetration. The average age at consultation was 30.39 ± 4.75 years. Most patients came from the island of Java (76.8%; 394/513), were undergraduates (83.3%; 309/371) and worked in the private sector (49.5%; 254/513). The median duration of vaginismus prior to presenting for treatment was 36 months (range 1-252 months). 45.8% (235/315) had experienced medical trauma previously, 46.6% (239/513) had marital trauma and 56.7% (291/513) had social trauma. 61.2% (314/513) attended follow-up and 89.4% (281/314) achieved penetration post-discharge. 23.7% (52/219) displayed involuntary movements during follow-up examination. Patients required a median of 4 weeks to achieve penetration and most achieved penetration at 1 Conclusion: Our assisted dilatation protocol, emphasizing on both multidisciplinary and multimodal approach, may be offered for standardized vaginismus treatment.
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