REMEDY : BNSSG referral pathways

Dyspareunia

Checked: 07-09-2017 by christopher.moloney Next Review: 31-01-2018

Dyspareunia and vaginismus

Please refer to the guidelines for the management of Dyspareunia (word doc) produced by Dr Rachel Brown, Gynaecology GPSI (Montpelier Health Centre)

Referral

Appropriate referral for treatment of dyspareunia depends on the underlying cause - see link to document above.

Psychological treatments are available via the Sexual Health Clinic.

Surgery may be required in the following circumstances:

  • Pelvic pathology such as masses, chronically infected tubes, endometriosis, adhesions - refer via eRS
  • Removal of sensitive scar tissue bridge can be highly effective when there is pain following episiotomy. Please note- episiotomy/perineal tear scar revision greater than 12 months following delivery is not routinely commissioned and requires prior approval according to the Female Genitalia Surgery Policy. If within 12  months of delivery patients can  be referred back to Obstetrics at the hospital where they delivered via direct referral - not available via eRS.
  • Fenton's operation (to enlarge a tight introitus) may help.
  • Ventrosuspension to 'correct' a retroverted uterus in an anteverted position is occasionally proposed but it is not known if it is effective as there are no randomised controlled trials of this procedure.