Evaluation of Genitopelvic Penetration Syndrome-Part (1): The Detailed History - Flowchart - Flowchart
Evaluation of Genitopelvic Penetration Syndrome-Part (1): The Detailed History - Flowchart - Flowchart Genitopelvic Pain/Penetration Syndrome Genitopelvic Pain/Penetration Syndrome
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Mostly meets this description

Mostly meets this description

Mostly meets this description

Mostly meets this description

Mostly meets this description

Mostly meets this description

Consider differential diagnosis:


    Provoked vestibulodynia
    Genitourinary syndrome of menopause
    Chronic vaginitis
    Recurrent tearing of posterior fourchette
    Vulvar dystrophy

Consider differential diagnosis:


    Provoked vestibulodynia
    Genitourinary syndrome of menopause
    Chronic vaginitis
    Recurrent tearing of posterior fourchette
    Vulvar dystrophy

Consider differential diagnosis:

Consider differential diagnosis:

    Provoked vestibulodynia
    Genitourinary syndrome of menopause
    Chronic vaginitis
    Recurrent tearing of posterior fourchette
    Vulvar dystrophy

Provoked vestibulodynia
Genitourinary syndrome of menopause
Chronic vaginitis
Recurrent tearing of posterior fourchette
Vulvar dystrophy

End

End

End

Consider differential diagnosis:


    Reflexive & chronic pelvic muscle hypertonicity “vaginismus”
    Deeper pelvic pathology (e.g., endometriosis)
    Comorbid vestibulodynia
    Comorbid genitourinary syndrome of menopause

Consider differential diagnosis:


    Reflexive & chronic pelvic muscle hypertonicity “vaginismus”
    Deeper pelvic pathology (e.g., endometriosis)
    Comorbid vestibulodynia
    Comorbid genitourinary syndrome of menopause

Consider differential diagnosis:

Consider differential diagnosis:

    Reflexive & chronic pelvic muscle hypertonicity “vaginismus”
    Deeper pelvic pathology (e.g., endometriosis)
    Comorbid vestibulodynia
    Comorbid genitourinary syndrome of menopause

Reflexive & chronic pelvic muscle hypertonicity “vaginismus”
Deeper pelvic pathology (e.g., endometriosis)
Comorbid vestibulodynia
Comorbid genitourinary syndrome of menopause

Introital
Burning/stinging/tearing
↑ with movement, but rarely absent if no movement
↑ with partner ejaculation
Postcoital burning
Postcoital dysuria

Introital
Burning/stinging/tearing
↑ with movement, but rarely absent if no movement
↑ with partner ejaculation
Postcoital burning
Postcoital dysuria



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↑

Introital

Introital +/– deeper
Body tenses with attempt at entry
“Pressure”; “hits a wall”; “too tight”
Absent if no movement
May lessen as movement continues
Not ↑ with partner ejaculation
No postcoital burning
No postcoital dysuria

Introital +/– deeper
Body tenses with attempt at entry
“Pressure”; “hits a wall”; “too tight”
Absent if no movement
May lessen as movement continues
Not ↑ with partner ejaculation
No postcoital burning
No postcoital dysuria






↑

Introital +/– deeper