A model for critical review of literature – with vaginismus as an example

Abstract

In this article we present a behavioral model for the critical review of the literature within a certain research field, using vaginismus as an example. We searched the literature for the title word "vaginismus" and analyzed to what extent the articles dealt with the following seven categories: prevention, etiology, maintaining factors, consequences, object of intervention, method of intervention, and method of evaluation. In each category we scrutinized the content of the articles for biological, psychological, social, relational, and gender aspects. Quality requirements of etiological and treatment studies were then added and the results presented in a "quality-adjusted" model. There were 102 articles during 1985-2001, of which 22 were included in the review. Most of the articles deal with supposed predisposing factors of etiology and different aspects of intervention. Only a few articles discuss precipitating factors, maintaining factors, or consequences of the problem. No article had a gender analysis. Only 11 of the articles fulfilled some of the proposed quality criteria. We found the behavioral model with quality requirements useful for classifying and evaluating the literature of vaginismus. The model may also be used as a guide to design methodologically good studies.

Long-Term Coital Behaviour in Women Treated with Cognitive Behaviour Therapy for Superficial Coital Pain and Vaginismus

“…Besides lacking randomization, many of the nonrandomized treatment studies have other methodological shortcomings (McGuire & Hawton, 2003;Reissing, Binik, & Khalife, 1999;van de Wiel, 1990;Wijma et al, 2007). A definition of vaginismus is often unclear or even absent.…”

“…In a majority of nonrandomized studies, positive treatment outcome has been defined as the woman's ability to have intercourse, and often success rates greater than 80%, even 100%, at end of therapy or at follow-up (3 -12 months) have been reported (Reissing et al, 1999;Wijma et al, 2007). In our study, the proportion of positive treatment outcome results at follow-up was highly associated with which definition of treatment outcome we chose to use and thus had a range of 75%: from 81% who were able to have intercourse to 6% who could have totally pain-free intercourse and were able to enjoy intercourse.…”

Dyspareunia and vaginismus: Review of the literature and treatment

“…[12][13][14][15] and on its partial overlap with vaginismus [1,3•, 6,7•]. Recent research has demonstrated persistent problems with the sensitivity and specificity of the differential diagnosis of these two phenomena [1,3•,5••, 6,12,[15][16][17][18][19]. However, as no consensus has been reached in unifying the two entities, they will be kept separate according to the latest classifications [10].…”

“…An intense debate is ongoing on the "real" nature of dyspareunia (is it a "sexual" or a "pain" disorder?) [12][13][14][15] and on its partial overlap with vaginismus [1,3•, 6,7•]. Recent research has demonstrated persistent problems with the sensitivity and specificity of the differential diagnosis of these two phenomena [1,3•,5••, 6,12,[15][16][17][18][19].…”

“…Sexual pain disorders-dyspareunia and vaginismus-are controversial entities [1,2•,3•,4•,5••,6,7•,8•, [9][10][11][12][13][14][15]. An intense debate is ongoing on the "real" nature of dyspareunia (is it a "sexual" or a "pain" disorder?)…”