{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:34:40Z","timestamp":1788395680128,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":518,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T00:00:00Z","timestamp":1628035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"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":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>In patients with vaginismus, the treatment becomes more challenging and the treatment may take longer as the grade of vaginismus is higher or worsens. However, the differences regarding treatment duration, success, and treatment methods by grades are not evident in the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>The aim of this study is to answer the question, \u201cDoes the number of treatment sessions, dilator requirement, treatment success, pre-&amp; post-treatment FSFI scores and obstetric results of vaginismus patients change depending on the vaginismus-grade?\u201d<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The patients were divided into 4 grades according to the Lamont classification. They underwent stepwise treatment sessions by a single gynecologist. Treatment success, duration of treatment, mechanical dilator requirement, duration from marriage, pre- and post-treatment FSFI scores, pregnancy rates, and delivery types were compared between patients at different grades.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Assessment of the differences between vaginismus-grades by comparing clinical observations and FSFI-scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Pain-free sexual intercourse occurred in 85 (93.4%) of 91 primary-vaginismus patients included in our study. The success rate was 100% in grade 1, 95.2% in grade 2, 92.1% in grade 3, and 92% in grade 4. Treatment session durations of the patients differed significantly by grades (P &amp;lt; .05). Same way the duration from marriage at the time of application differed significantly by the grade (P &amp;lt; .05). While there was a significant relationship between vaginismus grade and dilator requirement, there was no significant relationship between vaginismus grade and delivery type (P &amp;lt; .05). 54.5% of 44 patients, who got pregnant, delivered by cesarean-section. There was a significant increase in FSFI scores in all groups in the pre- and post-treatment third month (P &amp;lt; ,05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients should be notified that as the grades of vaginismus progress, the duration of the treatment may extend, and its success may decrease, the requirement for mechanical dilators will increase in the advanced grade, and the grade may progress as the application period for treatment is delayed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.esxm.2021.100407","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:17:09Z","timestamp":1628122629000},"page":"1-1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Examination of Treatment Duration, Treatment Success and Obstetric Results According to the Vaginismus Grades"],"prefix":"10.1093","volume":"9","author":[{"given":"Sevil","family":"Kiremitli","sequence":"first","affiliation":[{"name":"Erzincan Binali Yildirim University \u00a0 \u00a0 , Erzincan , Turkey"},{"name":"Medical Faculty \u00a0 \u00a0 , Erzincan , Turkey"},{"name":"Obstetrics and Gynaecology Department \u00a0 \u00a0 , Erzincan , Turkey"},{"name":"Private Neon Hospital \u00a0 , Erzincan , Turkey"},{"name":"Obstetrics and Gynaecology Department \u00a0 , Erzincan , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tunay","family":"Kiremitli","sequence":"additional","affiliation":[{"name":"Erzincan Binali Yildirim University \u00a0 \u00a0 , Erzincan , Turkey"},{"name":"Medical Faculty \u00a0 \u00a0 , Erzincan , Turkey"},{"name":"Obstetrics and Gynaecology Department \u00a0 \u00a0 , Erzincan , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,4]]},"reference":[{"key":"2023012008504037000_bib0001","article-title":"When sex seems impossible. 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