Department of Obstetrics and Gynecology, Universidade de Campinas-UNICAMP, Rua Alexandre Fleming, 101, São Paulo, Campinas, 13.083-880, Brazil.
Faculty of Medicine, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Canada.
Int Urogynecol J. 2022 Jun;33(6):1489-1494. doi: 10.1007/s00192-022-05147-z. Epub 2022 Mar 17.
To compare blood flow of the dorsal clitoral artery in women diagnosed with provoked vestibulodynia (PVD) and in healthy controls using color Doppler ultrasonography. We hypothesized that women with PVD would have a restricted blood flow compared to controls.
This cross-sectional study evaluated the function of the dorsal clitoral artery through the spectral wave analysis of color Doppler ultrasonography (US) in 20 women diagnosed with PVD according to Friedrich's criteria and 21 healthy controls. Participants were evaluated during their follicular phase and were asked to abstain from sexual activities 24 ho prior the examination. Assessment was performed by an assessor blinded to participant diagnosis, in the morning after a 10-min rest period in a supine lying position in a room with temperature set at 22 °C. Measurements of the peak systolic velocity (PSV), time-averaged maximum velocity (TAMX), end-diastolic velocity (EDV), pulsatility (PI) and resistance index (RI) were performed at rest considering the mean value of three consecutive waveforms.
Women with PVD and healthy controls did not present any statistically different baseline characteristics. Participants with PVD presented higher values of Doppler-US PSV, TAMX, EDV and RI compared to controls (p ≤ 0.05), which are suggestive of a decrease in blood flow. However, non-significant difference was found regarding PI values between the two groups (p > 0.05).
Our findings revealed decreased peripheral tissue perfusion in women with PVD compared to healthy controls using color Doppler US, based on the alteration of four of the five assessed data of US parameters.
使用彩色多谱勒超声检查对比诊断为诱发性外阴疼痛（PVD）的女性和健康对照者的阴蒂背侧动脉血流。我们假设与对照组相比，PVD 患者的血流受限。
这项横断面研究通过彩色多谱勒超声（US）的频谱波分析评估阴蒂背侧动脉的功能，纳入了 20 名根据 Friedrich 标准诊断为 PVD 的女性和 21 名健康对照者。参与者在卵泡期接受评估，并被要求在检查前 24 小时避免性行为。评估由一名评估者进行，评估者对参与者的诊断情况不知情，在室温为 22°C 的房间内，参与者仰卧位休息 10 分钟后，于上午进行评估。在休息时，对每个参与者连续三个波型的平均峰值收缩速度（PSV）、平均时间最大速度（TAMX）、舒张末期速度（EDV）、搏动指数（PI）和阻力指数（RI）进行测量，测量结果取三个波型的平均值。
患有 PVD 和健康对照组的女性在基线特征方面没有任何统计学差异。与对照组相比，患有 PVD 的参与者的多普勒-US PSV、TAMX、EDV 和 RI 值更高（p≤0.05），提示血流减少。然而，两组间的 PI 值无显著差异（p＞0.05）。
我们的发现表明，与健康对照组相比，使用彩色多谱勒超声检查发现 PVD 女性的外周组织灌注减少，这是基于对 5 个 US 参数中的 4 个数据的改变。
