Peker Hakan, Gursoy Ali
Nisantasi Vocational School, Nisantasi University, Istanbul, Turkey.
Faculty of Medicine, Department of Obstetrics and Gynecology, Maltepe University, Istanbul, Maltepe, Turkey.
J Sex Med. 2021 Jul;18(7):1230-1235. doi: 10.1016/j.jsxm.2021.05.004. Epub 2021 Jun 27.
To date, there is no certain method for diagnosis of genitourinary syndrome of menopause (GSM) and vaginal atrophy.
We aim to evaluate vaginal wall thickness (VWT) using 3D high frequency endovaginal ultrasound (3D EVUS) in GSM and also to investigate whether there is any association between VWT and postmenopausal sexual dysfunction.
Postmenopausal women applied for routine gynecologic examination were assessed at the Outpatient Clinic of Gynecology, Maltepe University Hospital. After pelvic examination, GSM symptoms were questioned for all women and vaginal health scoring tool was applied. Twenty women with GSM and 20 women without GSM were included in the study.
All patients filled in the Female Sexual Function Index (FSFI) and underwent 3D EVUS to evaluate VWT.
The women with GSM had significantly lower anterior and posterior VWT (P=.007 and P=.049, respectively). The total FSFI score, lubrication and pain sub-scores in patients with GSM was significantly lower than the patients without GSM. Anterior VWT was positively correlated with BMI and pain sub-score of FSFI (r=0.279, P=.047; r=0.344, P=.013, respectively). A significant negative correlation was detected between anterior vaginal VWT and age, time since menopause and satisfaction sub-score of FSFI (r=-0.332, P=.017; r=-0.354, P=.011; r=-0.301, P=.032, respectively). Posterior VWT was positively correlated with FSFI total score, arousal, lubrication and pain sub-scores (r=0.451, P=.001; r=0.437, P=.001; r=0.415, P=.002; r=0.335, P=.016; respectively).
Based on our results, measurement of VWT using 3D EVUS can be a useful non-invasive tool for the objective diagnosis of GSM.
Considering that only total vaginal thickness can be measured with traditional transabdominal and transvaginal techniques, the main strength of the study is the use of 3D EVUS for separate measurement of anterior and posterior VWT. The study has sufficient statistical power. The small sample size of study is the main limitation.
The 3D EVUS can be used for objective diagnosis of GSM and can also shed light on the causes of various sexual dysfunction symptoms in postmenopausal women, as it enables measuring the anterior and posterior walls of the vagina separately. Peker H, Gursoy A. Relationship Between Genitourinary Syndrome of Menopause and 3D High-Frequency Endovaginal Ultrasound Measurement of Vaginal Wall Thickness. J Sex Med 2021;18:1230-1235.
迄今为止，尚无确定的方法用于诊断绝经后泌尿生殖综合征（GSM）和阴道萎缩。
我们旨在使用三维高频经阴道超声（3D EVUS）评估GSM患者的阴道壁厚度（VWT），并研究VWT与绝经后性功能障碍之间是否存在关联。
在马尔泰佩大学医院妇科门诊对申请常规妇科检查的绝经后女性进行评估。盆腔检查后，询问所有女性的GSM症状，并应用阴道健康评分工具。纳入20例GSM患者和20例非GSM患者进行研究。
所有患者均填写女性性功能指数（FSFI），并接受3D EVUS以评估VWT。
GSM患者的前、后阴道壁厚度显著降低（分别为P = 0.007和P = 0.049）。GSM患者的FSFI总分、润滑和疼痛子评分显著低于非GSM患者。前阴道壁厚度与BMI和FSFI疼痛子评分呈正相关（分别为r = 0.279，P = 0.047；r = 0.344，P = 0.013）。前阴道壁厚度与年龄、绝经时间和FSFI满意度子评分之间存在显著负相关（分别为r = -0.332，P = 0.017；r = -0.354，P = 0.011；r = -0.301，P = 0.032）。后阴道壁厚度与FSFI总分、性唤起、润滑和疼痛子评分呈正相关（分别为r = 0.451，P = 0.001；r = 0.437，P = 0.001；r = 0.415，P = 0.002；r = 0.335，P = 0.016）。
基于我们的研究结果，使用3D EVUS测量VWT可能是一种用于客观诊断GSM的有用非侵入性工具。
考虑到传统经腹和经阴道技术只能测量阴道总厚度，本研究的主要优点是使用3D EVUS分别测量前、后阴道壁厚度。本研究具有足够的统计学效力。研究样本量小是主要局限性。
3D EVUS可用于GSM的客观诊断，还可阐明绝经后女性各种性功能障碍症状的原因，因为它能够分别测量阴道的前、后壁。佩克H，居尔索伊A。绝经后泌尿生殖综合征与三维高频经阴道超声测量阴道壁厚度的关系。《性医学杂志》2021；18：1230 - 1235。
