A Sexual Dysfunction And Quality Of Life Problems Caused By Perineal Pain Cicatrix In A Woman: A Case Report

Edy Fakhrizal(1), M. Lingga Primananda(2*)

(1) Obstetric and Gynecology Department, Faculty of Medicine, Riau University, Pekanbaru, Riau, Indonesia;
(2) Obstetric and Gynecology Resident, Faculty of Medicine, Riau University, Pekanbaru, Riau, Indonesia.
(*) Corresponding Author

DOI: https://doi.org/10.25077/aoj.7.1.338-341.2023

Abstract


Introduction: Sexual dysfunction is a complaint that could happened because of disturbance in complex process
which coordinated by neurology system, vascular and endocrine system.1 One cause of sexual disfunction is
dyspareunia which also followed by quality of life problems. Problems of dyspareunia, sexual dysfunction and
quality of life can be measure with VAS, FSFI and WHOQOL instruments. VAS, Visual Analogue Scale, is one of
the pain rating scales used in epidemiologic and clinical research to measure the intensity or frequency of various
symptoms.2 FSFI, Female Sexual Function Index, is a multidimensional questionnaire that can show female sexual
function. This questionnaire consists of 6 domains in which sexual desire, sexual arousal, lubrication, orgasm,
sexual satisfaction and pain.3,4,5 WHOQOL-BREF, World Health Organization Quality-of-Life Scale, is a quality
of life assessment developed by the WHOQOL Group with fifteen international field centres, simultaneously, in
an attempt to develop a quality of life assessment that would be applicated by cross-culturally.
Case Report : Patient came with complaint of pain in genital opening and perineum that felt since 5 months ago.
Patient also came with complaint of dyspareunia. Patient had history of vaginal delivery which causing her a
perineal rupture. For 5 months, patient could not get intercourse and made her desperated and suffered because
of her husband desire. Patient also felt inferiority and these problems disturbed her daily activity. VAS was 8,
FSFI was 3, and WHOQOL was 71. The perinel ruptured was sutured at the moment of delivery, but after 1 week
patient started to felt pain at her birth canal. It was the first pregnancy, delivery process was without any
problems, baby born with 2900 gram of birth weight. From gynecology examination, found a cicatrix at 5 o’clock
direction, any other gynecology organs within normal limit. Diagnose was dyspareunia ec perineal cicatrix with
sexual dysfunction and quality of life problems, then urogynecologist decided to do surgery


Keywords


sexual dysfunction, dyspareunia, quality of life

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