Department of Urogynaecology, The Warrell Unit, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Materno-Fetal Health Research Group, Faculty of Medical and Human Sciences, Institute of Human Development, University of Manchester, Manchester, UK.
Neurourol Urodyn. 2020 Feb;39(2):778-784. doi: 10.1002/nau.24282. Epub 2020 Jan 21.
Women with pelvic organ prolapse describe vaginal laxity and poor sensation of vaginal tone that does not correlate with anatomical findings. This discrepancy could be explained by altered vaginal sensation and a test that could measure sensation of vaginal tone, transmitted via Aα and Aβ nerve fibers, would further our understanding of the pathophysiology of vaginal laxity.
To develop quantitative sensory testing (QST) for vaginal tone using genital stretch perception thresholds (PT), assess reproducibility, and the association with age and parity.
Prospective observational cohort study of healthy women (Canadian task force classification II-2) who underwent QST method of limits at the vagina and introitus for sensation of first awareness and stretch using a modified anorectal physiology protocol.
Forty women underwent repeatability testing. Intra- and inter-rater repeatability using intraclass correlation coefficients (ICC) was good to excellent for both first awareness and stretch at the vagina and introitus (intra-rater ICC = 0.93, 0.95, 0.81, and 0.88, respectively; inter-rater ICC = 0.83, 0.93, 0.71, and 0.86 respectively). Normative data were collected from 100 women. Log-linear regression found a significant association between age and PT for first awareness and stretch at the vagina and introitus (P = .020, .008, .002, and <.001, respectively). There was no association with parity and PT. Nomograms were calculated using the 95% confidence limits around the regression line.
Stretch QST is clinically feasible, valid, and reproducible. The test can be used as a tool to measure sensation in women presenting with symptoms of vaginal laxity.
患有盆腔器官脱垂的女性会描述阴道松弛和阴道张力不佳的感觉，但这与解剖学发现不相关。这种差异可能是由于阴道感觉改变引起的，如果有一种可以测量阴道张力感觉的测试方法，通过 Aα 和 Aβ 神经纤维来传递，这将进一步了解阴道松弛的病理生理学。
开发一种使用生殖器伸展感知阈值（PT）的阴道张力定量感觉测试（QST），评估其可重复性，并评估其与年龄和产次的相关性。
对健康女性（加拿大任务组分类 II-2）进行前瞻性观察队列研究，使用改良的肛门直肠生理学方案，在阴道和入口处进行 QST 极限法，以感知第一感觉和伸展，并使用改良的肛门直肠生理学方案进行感知。
40 名女性接受了重复测试。使用组内相关系数（ICC）对内和间评分者的重复测试的可重复性进行评估，结果显示，在阴道和入口处的第一感觉和伸展的 ICC 均为良好至极好（内评分者 ICC 分别为 0.93、0.95、0.81 和 0.88；间评分者 ICC 分别为 0.83、0.93、0.71 和 0.86）。从 100 名女性中收集了正常数据。对数线性回归发现年龄与阴道和入口处第一感觉和伸展的 PT 之间存在显著相关性（P 分别为.020、.008、.002 和 <.001）。与产次无相关性。使用回归线的 95%置信区间计算了列线图。
伸展 QST 具有临床可行性、有效性和可重复性。该测试可作为评估阴道松弛症状女性感觉的工具。
