Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Translational Physiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Neurourol Urodyn. 2019 Jun;38(5):1298-1304. doi: 10.1002/nau.23977. Epub 2019 Apr 4.
This study aims to assess vaginal wall angioarchitecture and function in women with vulvovaginal atrophy (VVA) and determine the effect of topical estrogen on the vaginal microcirculation.
In this prospective observational study, incident dark field imaging was used to assess the vaginal microcirculation. In patients with VVA, measurements were performed before and after treatment with topical estrogen and compared to measurements performed in women without VVA. Vaginal angioarchitecture was studied by assessing microcirculatory architecture and capillary tortuosity scores at four regions of the vaginal wall. In addition, the capillary density and microvascular flow index (MFI) were obtained.
Seventeen women were included in this study. Of these, eight women were diagnosed with VVA and nine women were considered healthy controls. Significant differences were observed between groups with regard to microcirculatory architecture scores. The architecture of the microvasculature in women with VVA was characterized by the appearance of a vascular network without capillary loops, whereas an array of capillary loops was predominantly seen in women without VVA. After estrogen treatment, no difference in architecture scores between patients and healthy controls was observed. Capillary tortuosity, capillary density, and MFI were similar in both groups before and after estrogen treatment.
The architecture of vaginal microvasculature is altered in patients with VVA. In case of similar vascular architecture, capillary tortuosity and density seem to be comparable. Treatment with topical estrogen results in restoration of the angioarchitecture.
本研究旨在评估患有外阴阴道萎缩（VVA）的女性阴道壁血管结构和功能，并确定局部雌激素对阴道微循环的影响。
在这项前瞻性观察研究中，采用入射暗场成像来评估阴道微循环。在 VVA 患者中，在接受局部雌激素治疗前后进行测量，并与无 VVA 的女性进行比较。通过评估阴道壁四个区域的微血管结构和毛细血管扭曲评分来研究阴道血管结构。此外，还获得了毛细血管密度和微血管血流指数（MFI）。
本研究纳入了 17 名女性。其中，8 名女性被诊断为 VVA，9 名女性被认为是健康对照组。在微循环结构评分方面，两组之间存在显著差异。VVA 女性的微血管结构表现为无毛细血管环的血管网络外观，而健康对照组女性主要表现为毛细血管环阵列。雌激素治疗后，患者和健康对照组之间的结构评分无差异。雌激素治疗前后，两组的毛细血管扭曲度、毛细血管密度和 MFI 相似。
VVA 患者的阴道微血管结构发生改变。在具有相似血管结构的情况下，毛细血管扭曲度和密度似乎可以相媲美。局部雌激素治疗可恢复血管结构。
