title: Unconsummated marriage: clarification of aetiology; treatment with intracorporeal injection.
abstract: OBJECTIVE
  To clarify the aetiological factors in unconsummated marriage in Iran, and to report the results of intracorporeal injection therapy for erectile dysfunction in these circumstances.
  
  
  METHODS
  During a 2-year period, 200 cases of unconsummated marriage were evaluated. A detailed history was obtained to clarify the circumstances of the problem; if simple measures failed to resolve the problem, intracorporeal injection with papaverine +/- phentolamine was used.
  
  
  RESULTS
  The main factor associated with an unconsummated marriage was the intense social pressure to accomplish hasty coitus with an unfamiliar woman (some men having had no social contact with their new bride) and in the presence of relatives waiting nearby for evidence of the bride's virginity and confirmation of coitus. The initial problem was then further compounded with resultant erectile failure caused by anxiety about sexual performance. Inability to consummate the marriage was caused by premature ejaculation in 23%, erectile dysfunction in 61%, and a combination in 16%; 70% of patients were able to consummate the union after intracorporeal injection with papaverine +/- phentolamine.
  
  
  CONCLUSIONS
  In addition to psychological causes and a lack of sexual education, the social circumstances in which partners are obliged to initiate and complete coitus are important factors in the aetiology of unconsummated marriage. Intracorporeal injection is useful in treating this problem and it should be the therapy of choice for unconsummated marriage in developing countries, where the conditions do not favour psychotherapy and where alternative erectogenic agents are expensive or unavailable.
authors.affiliation: Department of Urology, Kermanshah University of Medical Sciences, Iran. zargooshi@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: Zargooshi
mesh_terms: D000293:Adolescent; D000328:Adult; D004542:Ejaculation; D007172:Erectile Dysfunction; D005260:Female; D006801:Humans; D007267:Injections; D007492:Iran / Q000453:epidemiology; D008297:Male; D008393:Marriage; D010208:Papaverine / Q000008:administration & dosage; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology*; D013565:Sympatholytics / Q000008:administration & dosage; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D013565:Sympatholytics; D014665:Vasodilator Agents; D010208:Papaverine