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Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. VII. Sexual Dysfunctions: 1. Long-Term Unconsummated Marriage

Rabea Ahmed Gadelkareem, Ahmed Abdelhameed Shahat, Ahmed Mohammed Moeen, Mohamed Farouk Abdelhafez, Amr Abou Faddan, Mahmoud Mohammed Osman, Ali Farrag Elhadad, Mohammed Abbas Faragallah, Adel Kurkar and Ahmed Mohammed El-Taher

Objective: To present our center’s experience with cases of long-term unconsummated marriage and the effect of traditional beliefs on seeking proper treatment. Methods: A retrospective search of our patients’ records was done for the reported cases of long-term unconsummated marriage during the period of July 1991-June 2016. Each case was studied for the demographic characteristics including marital ones, clinical works up, and management. Results: Eighteen couples had an unconsummated marriage that ranged between 7 months and 13 years. Averages of age (mean ± SD) of husbands and wives at disclosure were 24-43 (30.9 ± 5.1) and 19-32 (24.9 ± 3.4) years, respectively. Thirteen couples (72.2%) had rural residence and 15 couples (83.3%) had middle or lower education levels. The underlying etiology was a male factor in 12 cases (66.7%) due to premature ejaculation (16.7%), vasculogenic erectile dysfunction (33.3%), or psychogenic causes (11.1%). The female factor was the cause in 3 cases (16.7%) due to vaginismus (11.1%) or phobia of vaginal penetration (5.5%). All the couples attributed concealment of their conditions to the fear of societal embarrassment on disclosure and expressed beliefs in spiritual factors for etiology. The majority of couples sought traditional treatments including religious rituals or spells (88.9%) and traditional medicines (77.8%), while only 55.5% of cases received allopathic medications. Only 5 couples (27.8%) succeeded to consummate the marriage. Of the divorced 13 couples, 4 couples (30.7%) dropped out thereafter, but 9 females (69.2%) and only 3 males (33%) had consummated the second marriage. Conclusion: Long-term unconsummated marriage among the heterosexual couples is very rare with different underlying etiologies and high potentials for divorce. It may be concealed for several years without evaluation and proper treatment due to the constraints of low socioeconomic standards and sociocultural and traditional beliefs about its etiology and treatment.