Pereira Glaucia Miranda Varella, de Almeida Cristiane Martins, Martinho Natalia, Jarmy-Di-Bella Zsuzsanna Ilona Katalin, de Andrade Kleber Cursino, Sartori Marair Gracio Ferreira, Juliato Cassia Raquel Teatin, Brito Luiz Gustavo Oliveira
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Department of Gynecology, Medical School, Federal University of São Paulo, São Paulo, Brazil.
Neurourol Urodyn. 2025 Apr;44(4):775-786. doi: 10.1002/nau.25669. Epub 2025 Jan 30.
To compare the vaginal wall thickness (VWT) measurement by two-dimensional ultrasound (2D-US) and pelvic floor muscle morphometry by four-dimensional translabial ultrasound (4D-TLUS) in women with vaginal laxity (VL) who underwent treatment with radiofrequency (RF) or pelvic floor muscle training (PFMT) after 30 days and 6 months.
A secondary analysis of a randomized clinical trial that occurred between February 2020 and December 2021 was performed. Women with VL were enrolled and treated with RF or PFMT for 12 weeks. Ultrasound examiners were blinded for the groups. Transabdominal (TAUS) and transvaginal (TVUS) ultrasound were performed with 2D-US analysis. The 4D-TLUS was used for PFM morphometry assessment. We performed per-protocol and intention-to-treat analysis (5% significance).
Women with ballooning presented significantly worse scoring in sexual function (p = 0.037) and vaginal symptoms (p = 0.007) than women without ballooning. Analysis of variance among 2D-US, intervention groups and assessment periods has shown that measurements of the TAUS proximal vagina increased in the PFMT group after 6 months (from 9.90 ± 3.14 mm to 10.53 ± 2.71 mm; p = 0.006). TAUS/TVUS distal vagina measurements were reduced after 6 months of RF (TAUS from 11.79 ± 3.67 mm to 10.51 ± 2.51 mm; p = 0.018/TVUS from 7.94 ± 1.83 mm to 7.32 ± 2.10 mm; p = 0.037). On the other hand, 4D-TLUS measurements did not present differences according to the intervention and/or groups.
Women with ballooning on 4D-TLUS presented significantly worse scoring in sexual function and vaginal symptoms. 2D-US found that RF reduced the VWT of the distal vagina after 6 months and PFMT increased the VWT of the proximal vagina after 6 months.
Registro Brasileiro de Ensaios Clínicos-REBEC-RBR-2zdvfp as a clinical trial.
比较二维超声（2D-US）测量阴道壁厚度（VWT）和四维经阴唇超声（4D-TLUS）测量盆底肌肉形态学指标，观察30天及6个月后接受射频（RF）治疗或盆底肌肉训练（PFMT）的阴道松弛（VL）女性的情况。
对2020年2月至2021年12月间进行的一项随机临床试验进行二次分析。纳入VL女性，给予RF或PFMT治疗12周。超声检查人员对分组情况不知情。采用2D-US分析进行经腹（TAUS）和经阴道（TVUS）超声检查。4D-TLUS用于盆底肌肉形态学评估。我们进行了符合方案分析和意向性分析（显著性水平为5%）。
4D-TLUS显示有阴道膨出的女性在性功能（p = 0.037）和阴道症状（p = 0.007）方面的评分显著低于无阴道膨出的女性。2D-US、干预组和评估期之间的方差分析表明，PFMT组在6个月后TAUS测量的近端阴道厚度增加（从9.90±3.14毫米增至10.53±2.71毫米；p = 0.006）。RF治疗6个月后TAUS/TVUS测量的远端阴道厚度降低（TAUS从11.79±3.67毫米降至10.51±2.51毫米；p = 0.018/TVUS从7.94±1.83毫米降至7.32±2.10毫米；p = 0.037）。另一方面，4D-TLUS测量结果在不同干预措施和/或组间未显示出差异。
4D-TLUS显示有阴道膨出的女性在性功能和阴道症状方面的评分显著更差。2D-US发现RF治疗6个月后可降低远端阴道的VWT，PFMT治疗6个月后可增加近端阴道的VWT。
巴西临床试验注册中心 - REBEC - RBR - 2zdvfp作为一项临床试验。
