{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:54:52Z","timestamp":1790794492872,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":2108,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T00:00:00Z","timestamp":1490659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2017,3,7]],"date-time":"2017-03-07T00:00:00Z","timestamp":1488844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["smoa.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Vaginismus is mostly unknown among clinicians and women. Vaginismus causes women to have fear, anxiety, and pain with penetration attempts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To present a large cohort of patients based on prior published studies approved by an institutional review board and the Food and Drug Administration using a comprehensive multimodal vaginismus treatment program to treat the physical and psychologic manifestations of women with vaginismus and to record successes, failures, and untoward effects of this treatment approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Assessment of vaginismus included a comprehensive pretreatment questionnaire, the Female Sexual Function Index (FSFI), and consultation. All patients signed a detailed informed consent. Treatment consisted of a multimodal approach including intravaginal injections of onabotulinumtoxinA (Botox) and bupivacaine, progressive dilation under conscious sedation, indwelling dilator, follow-up and support with office visits, phone calls, e-mails, dilation logs, and FSFI reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Logs noting dilation progression, pain and anxiety scores, time to achieve intercourse, setbacks, and untoward effects. Post-treatment FSFI scores were compared with preprocedure scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred seventy-one patients (71%) reported having pain-free intercourse at a mean of 5.1 weeks (median\u00a0= 2.5). Six patients (2.5%) were unable to achieve intercourse within a 1-year period after treatment and 64 patients (26.6%) were lost to follow-up. The change in the overall FSFI score measured at baseline, 3\u00a0months, 6 months, and 1 year was statistically significant at the 0.05 level. Three patients developed mild temporary stress incontinence, two patients developed a short period of temporary blurred vision, and one patient developed temporary excessive vaginal dryness. All adverse events resolved by approximately 4 months. One patient required retreatment followed by successful coitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A multimodal program that treated the physical and psychologic aspects of vaginismus enabled women to achieve pain-free intercourse as noted by patient communications and serial female sexual function studies. Further studies are indicated to better understand the individual components of this multimodal treatment program.<\/jats:p>\n                    <jats:p>Pacik PT, Geletta S. Vaginismus Treatment: Clinical Trials Follow Up 241 Patients. Sex\u00a0Med 2017;5:e114\u2013e123.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.esxm.2017.02.002","type":"journal-article","created":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T21:30:36Z","timestamp":1490736636000},"page":"e114-e123","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":64,"title":["Vaginismus Treatment: Clinical Trials Follow Up 241 Patients"],"prefix":"10.1093","volume":"5","author":[{"given":"Peter T.","family":"Pacik","sequence":"first","affiliation":[{"name":", Dunbarton, NH, \u00a0USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Geletta","sequence":"additional","affiliation":[{"name":"Department of Statistics , Des Moines, IA, \u00a0 USA"},{"name":"Des Moines University , Des Moines, IA, \u00a0 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,3,28]]},"reference":[{"key":"2023011909323913300_bib1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","article-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2013"},{"key":"2023011909323913300_bib2","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1007\/s10508-009-9560-0","article-title":"The DSM diagnostic criteria for vaginismus","volume":"39","author":"Binik","year":"2010","journal-title":"Arch Sex Behav"},{"key":"2023011909323913300_bib3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/B:ASEB.0000007458.32852.c8","article-title":"Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus","volume":"33","author":"Reissing","year":"2004","journal-title":"Arch Sex Behav"},{"key":"2023011909323913300_bib4","first-page":"24","article-title":"Summary of the recommendations on sexual dysfunctions in women","volume":"1","author":"Basson","year":"2004","journal-title":"J\u00a0Sex Med"},{"issue":"1\u20132","key":"2023011909323913300_bib5","article-title":"An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind\/body connection","volume":"28","author":"Rosenbaum","year":"2013","journal-title":"Sex Relatsh Ther"},{"key":"2023011909323913300_bib6","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1007\/s00266-011-9737-5","article-title":"Vaginismus: review of current concepts and treatment using Botox injections, bupivacaine injections, and progressive dilation with the patient under anesthesia","volume":"35","author":"Pacik","year":"2011","journal-title":"Aesthetic Plast Surg"},{"key":"2023011909323913300_bib7","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1007\/s00192-014-2421-y","article-title":"Understanding and treating vaginismus: a multimodal approach","volume":"25","author":"Pacik","year":"2014","journal-title":"Int Urogynecol J"},{"key":"2023011909323913300_bib8","article-title":"When sex seems impossible. 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