Sudol Neha Talreja, Miao Yusi, Li Yan, Chen Jason J, Jing Joseph C, Zhu Jiang, Tadir Yona, Chen Zhongping, Lane Felicia
Beckman Laser Institute.
From the Department of Obstetrics & Gynecology, University of California Irvine Medical Center, Orange.
Female Pelvic Med Reconstr Surg. 2020 Feb;26(2):155-158. doi: 10.1097/SPV.0000000000000839.
Optical coherence tomography is a noninvasive technology that visualizes tissue microstructure with high spatial resolution. We designed a novel vaginal system that demonstrates a clear distinction between vaginal tissues planes. In this study, we sought to compare vaginal tomographic images of premenopausal, perimenopausal, and postmenopausal women, demonstrate feasibility of tracking vaginal tissue changes after treatment with fractional-pixel CO2 laser therapy, and obtain a histologic correlation of these findings.
Enrolled subjects underwent imaging and were divided into 3 groups based on menopausal status. Women with genitourinary syndrome of menopause who received fractional-pixel CO2 laser therapy were assessed before and after treatment. A cadaveric vagina was used to obtain tomographic and histologic images to assess for accuracy. Our primary outcome was mean vaginal epithelial thickness. Statistical analysis was performed using analysis of variance and t tests, respectively.
Among 6 women, the mean vaginal epithelial thickness decreased with menopause (P < 0.01). Although change in epithelial thickness after fractional-pixel CO2 laser treatment varied between the 2 subjects evaluated, it increased significantly for the subject who reported improvement of vaginal symptoms (P < 0.01). Using a cadaveric specimen, optical biopsy was correlated to an hematoxylin and eosin-stained biopsy of the same vaginal site.
This study establishes feasibility of optical coherence tomography in providing an optical biopsy of the vaginal epithelium and lamina propria. In addition, it demonstrates vaginal changes as women enter menopause. This report is the initial phase of a longitudinal cohort study to evaluate changes in vaginal microstructure after energy-based treatment.
光学相干断层扫描是一种非侵入性技术，可在高空间分辨率下可视化组织微观结构。我们设计了一种新型阴道系统，该系统能清晰区分阴道组织层面。在本研究中，我们旨在比较绝经前、围绝经期和绝经后女性的阴道断层图像，证明分数像素二氧化碳激光治疗后追踪阴道组织变化的可行性，并获得这些发现的组织学相关性。
纳入的受试者接受成像，并根据绝经状态分为3组。对接受分数像素二氧化碳激光治疗的绝经泌尿生殖综合征女性在治疗前后进行评估。使用一具尸体阴道获取断层图像和组织学图像以评估准确性。我们的主要结局是平均阴道上皮厚度。分别使用方差分析和t检验进行统计分析。
在6名女性中，平均阴道上皮厚度随绝经而降低（P < 0.01）。尽管分数像素二氧化碳激光治疗后上皮厚度的变化在2名接受评估的受试者之间有所不同，但报告阴道症状改善的受试者其上皮厚度显著增加（P < 0.01）。使用尸体标本，光学活检与同一阴道部位的苏木精和伊红染色活检相关。
本研究证实了光学相干断层扫描在提供阴道上皮和固有层光学活检方面的可行性。此外，它还展示了女性进入绝经时的阴道变化。本报告是一项纵向队列研究的初始阶段，旨在评估基于能量的治疗后阴道微观结构的变化。
