In her late twenties, she came to the Gynaecology clinic with a few complaints. She is married with 2 children, the youngest being 5-year-old and unable to conceive there after. Her menstruation was irregular but heavy. She complained of something coming down through her coital passage. After detail history, physical examination and relevant investigations, she was diagnosed
polycystic ovarian syndrome and reducible second degree
uterovaginal prolapse with retroverted uterus and cervical elongation.
(For the benefit of the non-medical personnel, it means the prolapse of part of the genital tract just enough to block the vagina passage.)Doctor explained to her regarding her conditions and the available treatment options, including surgical treatment of cervical shortening. Out of which she was advised only for conservative treatments such as weight reduction, pelvic floor muscle exercise and to minimize straining. The patient didn't seem to be satisfied and repeatedly questioned the doctor of the ways to get rid of the prolapse. She started tearing and expressed how this problem had interfered her sexual intercourse and the relationship with her husband. She couldn't meet her husband's pleasure.
Things must have been bothering enough for a woman to tear in front of public (9 medical students, a doctor and a staff nurse). Her major concern wasn't how to get pregnant or why is she menstruating abnormally but how to restore the husband and wife relationship.
Bearing in mind that the conservative treatments take time and the efficiency is very much less than that of surgical intervention, I would want to sign her for cervical shortening and simultaneously advise her for the above mentioned modifications to reduce the
risk of recurrence. My idea got rejected by the doctor, I felt helpless.
She needs a space, in her vagina just enough for sexual intercourse. She needs a space in her husband's heart. She needs a little more consideration.
Undoubtedly, sex is an important act to a marriage. But why should it comes to take a place in causing marital disharmony? Isn't love supposed to be greater? Why are women always the ones silly enough to consider for everyone else except for themselves?
Perhaps I am not being realistic enough. Or I am just too emotional...
I regretted of not going after the patient to talk to her more. She must have stepped out of the consultation room feeling more miserable than she just stepped in.
Sincerely, hope things are fine with her.
*Useful facts
