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Non-Consummated Marriage India

Clinical Relevance and Therapeutic guidelines for your questions

DrVijayKulkarni
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Non-Consummated Marriage India

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  1. Doctor,​​​​We​​​​are​​​​not​​​​sure​​​​we​​​​are​​​​doing​​​​it​​​​right Clinical​​​​Relevance Both​​are​​unsure​​as​​to​​what​​exactly​​is​​supposed​​to​​happen​​in​​an​​intercourse,​​hence are​​not​​sure​​how​​to​​achieve​​it Therapeutic​​​​guidelines ● Ensure​​normal​​erection ● Explain​​Genital​​anatomy, ● What​​is​​an​​intercourse​​&​​the​​necessary​​Coital​​position Doctor,​​​​We​​​​have​​​​not​​​​been​​​​able​​​​to​​​​make​​​​it​​​​so​​​​far Clinical​​​​interpretation Both​​are​​aware​​that​​penetration​​has​​not​​yet​​occurred​​in​​their​​sexual​​relationship They​​have​​basic​​knowledge​​of​​sexual​​intercourse. Therapeutic​​​​guidelines ● Ensure​​normal​​erection ● Explain​​anatomy​​&​​coital​​position Doctor,​​​​She​​​​does​​​​not​​​​allow​​​​me Clinical​​​​Relevance He​​knows​​that​​his​​erection​​is​​no​​problem​​but​​penetration​​has​​not​​occurred​​as​​she​​is not​​allowing​​it​​.​​Probably​​even​​she​​is​​also​​aware​​of​​the​​fact​​but​​can’t​​help​​it Therapeutic​​​​guidelines ● Concentrate​​on​​female​​partner ● Exclude​​vaginismus ● Allay​​anxiety,​​fear​​of​​pain ● Self-dilatation Read​​More​​at​​​http://www.drvijaykulkarni.com/

  2. I​​​​think​​​​I​​​​am​​​​impotent Clinical​​​​interpretation He​​is​​convinced​​that​​he​​is​​impotent And​​that​​he​​alone​​is​​the​​cause​​of​​the​​non-consummation High​​degree​​of​​performance​​anxiety Has​​developed​​psychogenic​​ED Therapeutic​​​​guidelines ● Counsel​​the​​male,​​help​​him​​get​​rid​​of​​inferiority​​complex,​​ensure​​his erection​​with​​erectogenic​​drugs ● Ensure​​female’s​​active​​participation I​​​​am​​​​ok,​​​​but​​​​she​​​​does​​​​not​​​​feel​​​​it Clinical​​​​Relevance Subtle​​shades​​of​​a​​MCP-​​knows​​he​​gets​​erection,​​believes​​he​​penetrates​​because he​​can​​ejaculate.​​He​​is​​at​​a​​total​​loss​​to​​understand​​as​​to​​how​​she​​can​​not​​feel​​it Therapeutic​​​​guidelines Male​​–​​Make​​him​​understand​​that​​he​​can​​ejaculate​​inbet​​labia​​without​​penetration Female​​–​​Positioning​​her​​pelvis​​to​​facilitate​​penetration,​​Self​​dilatation Read​​More​​at​​​http://www.drvijaykulkarni.com/

  3. My​​​​wife​​​​is​​​​upset;​​​​saying​​​​I​​​​need​​​​treatment Clinical​​​​interpretation The​​differences​​due​​to​​UCM​​are​​sharp​​but​​not​​yet​​irreconcilable.​​He​​probably​​has developed​​psychogenic​​ED Therapeutic​​​​guidelines Necessary​​to​​counsel​​the​​couple​​and​​assure​​the​​female​​that​​this​​problem​​is solvable.​​Also​​that​​she​​has​​equal​​role​​to​​play​​in​​solving​​it.​​And​​treat​​his​​ED. I​​​​need​​​​a​​​​certificate​​​​of​​​​my​​​​potency​​​​as​​​​my​​​​wife​​​​has​​​​filed for​​​​divorce Clinical​​​​Relevance Too​​late,​​missed​​the​​bus​​Make​​sure​​whether​​he​​has​​ED-psychogenic​​or​​Organic Therapeutic​​​​guidelines Pharmacologically​​Induced​​Erection​​Test​​Nocturnal​​Penile​​Tumescence​​(NPT) Make​​sure​​he​​is​​capable​​of​​consummating​​his​​second​​marriage We​​​​do​​​​not​​​​have​​​​a​​​​baby​​​​yet Clinical​​​​interpretation Supremely​​Ignorant​​couple​​!​​Never​​doubted​​that​​what​​they​​were​​doing​​as​​sex​​was not​​an​​intercourse​​and​​expected​​a​​pregnancy​​out​​of​​it. Therapeutic​​​​guidelines Extensive​​psychosexual​​counseling​​Protocol​​for​​UCM Read​​More​​at​​​http://www.drvijaykulkarni.com/

  4. Protocol​​​​for​​​​the​​​​male ● Assess​​Erectile​​Function​​by ○ Pharmacologically​​Induced​​Erection​​(PIE)​​test​​with Intra-Corporal​​Inj​​or​​PDE5​​Inhibitor​​trial ○ NPTR​​(​​Rigiscan)-​​Nocturnal​​Penile​​Tumescence​​&​​Rigidity ● Therapeutic​​dose​​determination​​(TDD)​​of​​Either​​modality​​i.e.​​Oral​​or Self-Injection ● Ensure​​sustained​​Erection​​with​​rigidity​​on​​demand Drugs​​​​Used ● Oral-​​PDE5​​Inhibitors: ○ Sildenafil​​50,​​100​​mg ○ Tadalafil​​10​​,​​20​​mg ○ Vardenafil​​5​​,​​10​​mg ● Intra​​Cavernosally​​Injectable: ● Papaverine​​+​​Phentolamine​​or​​Chlorpromazine​​Prostaglandin​​E1 IntraCavernosal​​​​Injection​​​​of​​​​VasoActive​​​​Drugs (ICIVAD) STEPS ● Therapeutic​​Dose​​Determination(TDD) ● Supervised​​Injection​​Program​​(SIP) ● Home​​Self-Injection​​Program​​(HSIP) ● Wife-assisted​​Home​​Injection​​Program(WHIP) Read​​More​​at​​​http://www.drvijaykulkarni.com/

  5. Penile​​​​Prosthesis Only​​​​when​​​​organicity​​​​is​​​​proved​​​​​​Inflatable​​&​​Non-Inflatable Unsuitable​​​​Modalities ● VED ○ Lacks​​spontaneity ○ Rigidity​​inadequate​​for​​the​​1st​​penetration ○ Cumbersomeness​​causes​​more​​anxiety ● Vascular​​Surgery ○ Delayed​​result ○ Uncertain​​outcome Counseling​​​​the​​​​Couple ● Explain​​the​​anatomy​​of​​Male​​&​​Female​​genitalia ● Explain​​the​​need,​​by​​diagram,​​to​​tilt​​the​​pelvis​​to​​facilitate​​penetration ● Diagrammatic​​coital​​positions​​which​​the​​couple​​can​​find​​comfortable ● ASSURANCE​​of​​no​​pain​​to​​female ● ALLAY​​the​​fear​​of​​failure​​of​​male Read​​More​​at​​​http://www.drvijaykulkarni.com/

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