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Hady DAA, Mabrouk OM, Osman DA. Ultrasound imaging of core muscles activity in multiparous women with vaginal laxity: a cross-sectional study. Sci Rep 2024; 14:9063. [PMID: 38643221 PMCID: PMC11032349 DOI: 10.1038/s41598-024-58955-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
Vaginal laxity (VL) is a common condition among multiparous women, especially those who have delivered vaginally. Since pelvic floor muscles (PFMs) work synergistically with other core muscles, physical therapy protocols that aim to treat VL should train the PFMs in combination with other core muscles. To investigate the activity of core muscles in multiparous women with and without VL, and its relation to sexual function. An observational, cross-sectional study. The study included 100 multiparous women, who were divided into two groups according to their scores on the vaginal laxity questionnaire (VLQ). Women who scored between 1 and 3 on the VLQ were categorized as having VL (n = 48), while those who scored between 5 and 7 were placed in the control group (n = 52). The primary outcomes were PFM displacement, diaphragmatic excursion, transversus abdominis activation ratio, and lumbar multifidus thickness measured by ultrasound imaging. The secondary outcome was sexual functioning, evaluated using the Arabic female sexual function index (ArFSFI). The VL group had significantly lower PFM displacement (mean difference (MD) - 0.42; 95% confidence interval (CI) - 0.49 to - 0.33; p = 0.001), diaphragmatic excursion (MD - 2.75; 95% CI - 2.95 to - 2.55; p = 0.001), lumbar multifidus thickness (MD - 10.08; 95% CI - 14.32 to - 5.82; p = 0.02), and ArFSFI scores (MD - 9.2; 95% CI - 10.59 to - 7.81; p = 0.001) in comparison to the control group (p < 0.05). Nevertheless, the transversus abdominis activation ratio demonstrated no significant difference between the two groups (MD 0.06; 95% CI - 0.05 to 0.17; p = 0.33). Multiparous women with VL had significantly lower PFM displacement, diaphragmatic excursion, lumbar multifidus thickness, and sexual function index scores than women in the control group. The only exception was transversus abdominis activation, which did not differ significantly between the VL and control groups.
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Affiliation(s)
- Doaa A Abdel Hady
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Deraya University, Minia, Egypt.
| | - Omar M Mabrouk
- Department of Basic Science, Faculty of Physical Therapy, Deraya University, Minia, Egypt
| | - Doaa A Osman
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Fu L, Long S, Li Q, Xu H, Guo L, Wang H, Zheng Z, Zhang J. The efficacy and safety of temperature controlled dual-mode radiofrequency in women with vaginal laxity. BMC Womens Health 2023; 23:121. [PMID: 36959573 PMCID: PMC10035145 DOI: 10.1186/s12905-023-02261-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/06/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE Vaginal laxity could negatively influence women's sexual function. This study aimed to explore the efficacy and safety of temperature controlled dual-mode (monopolar and bipolar) radiofrequency (RF) in women with vaginal laxity. METHODS A total of 102 patients with vaginal laxity were treated with temperature-controlled RF. The present study implemented Vaginal Laxity Questionnaire (VLQ), Female Sexual Function Index (FSFI) questionnaire and Sexual Satisfaction Questionnaire (SSQ) on all patients at baseline and after treatment. Pelvic Organ Prolapse Quantification System (POP-Q) system was applied to physical examination, and vaginal manometer to examine the strength of voluntary contractions of the pelvic floor muscles. RESULTS The VLQ score was gradually increased after RF treatment at 1, 3, 6 and 12 months, accompanying by the significant improvement in total FSFI scores and the six domains (sexual desire, sexual arousal, lubrication, orgasm, satisfaction, pain). The increased sexual satisfaction based on the SSQ score was found after temperature-controlled RF. The result of POP-Q stage showed significant difference in women after treatment, with the women having Stage I of 45.10% at baseline, 36.27% at 1 month, 28.43% at 3 months, 19.61% at 6 months and 10.78% at 12 months. The mean pressure and mean duration of pelvic contractions were increased gradually at the 1-, 3-, 6- and 12- month follow-up. CONCLUSION Temperature controlled dual-mode (monopolar and bipolar) radiofrequency may be associated with improvement of vaginal laxity, and contribute to enhancement to female sexual function and pelvic floor muscles.
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Affiliation(s)
- Lixia Fu
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China
| | - Senyang Long
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China
| | - Qin Li
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China
| | - Hainan Xu
- Department of Obstetrics and Gynecology, Pelvic Floor Disease Diagnosis and Treatment Center, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, China
| | - Ling Guo
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China
| | - Huarong Wang
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China
| | - Zhongyan Zheng
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China
| | - Jing Zhang
- Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, 611731, Chengdu, Sichuan Province, China.
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Wamsley C, Kislevitz M, Vingan NR, Oesch S, Lu K, Barillas J, Hoopman J, Akgul Y, Basci D, Kho K, Zimmern PE, Kenkel JM. A Randomized, Placebo-Controlled Trial Evaluating the Single and Combined Efficacy of Radiofrequency and Hybrid Fractional Laser for Nonsurgical Aesthetic Genital Procedures in Post-Menopausal Women. Aesthet Surg J 2022; 42:1445-1459. [PMID: 35882474 DOI: 10.1093/asj/sjac202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The efficacy of interventions that provide long-term relief of genitourinary symptoms of menopause has not been determined. OBJECTIVES The authors sought to evaluate radiofrequency and hybrid fractional laser (HFL) treatments for menopausal vulvovaginal symptoms. METHODS Thirty-one postmenopausal women completed all treatments and at least 1 follow-up. Outcomes included the Vulvovaginal Symptom Questionnaire (VSQ), Vaginal Laxity Questionnaire (VLQ), Urogenital Distress Short Form, Incontinence Impact Questionnaire (IIQ), Female Sexual Function Index (FSFI), laxity measurements via a vaginal biometric analyzer probe, and gene expression studies. RESULTS Mean VSQ score decreased 2.93 (P = 0.0162), 4.07 (P = 0.0035), and 4.78 (P = 0.0089) among placebo, dual, and HFL groups 3 months posttreatment and decreased to 3.3 (P = 0.0215) for dual patients at 6 months. FSFI scores increased in the desire domain for placebo and dual groups and in arousal, lubrication, orgasm, satisfaction, and pain domains for the HFL group 3 and 6 months posttreatment. An increase of 1.14 in VLQ score (P = 0.0294) was noted 3 months and 2.2 (P = 0.002) 6 months following dual treatment. There was also a mean decrease of 15.3 (P = 0.0069) in IIQ score for HFL patients at 3 months. Dual, HFL, and RF treatments resulted in statistically significant decreases in collagen I, elastin, and lysyl oxidase expression. CONCLUSIONS Several self-reported improvements were noted, particularly among HFL, dual, and placebo groups 3 and 6 months posttreatment. Objective biopsy analysis illustrated decreased gene expression, suggesting that treatments did not stimulate new extracellular matrix production. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Christine Wamsley
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Mikaela Kislevitz
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nicole R Vingan
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sydney Oesch
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Karen Lu
- Department of Plastic Surgery, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jennifer Barillas
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John Hoopman
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yucel Akgul
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Deniz Basci
- plastic surgeon in private practice in Dallas, TX, USA
| | - Kimberly Kho
- Department of Obstetrics and Gynecology, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Phillipe E Zimmern
- Department of Urology, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey M Kenkel
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Pereira GMV, Juliato CRT, de Almeida CM, Valente IS, de Andrade KC, Brito LGO. Measurement of the vaginal wall thickness by transabdominal and transvaginal ultrasound of women with vaginal laxity: a cross-sectional study. Int Urogynecol J 2022; 33:3563-3572. [PMID: 35384478 DOI: 10.1007/s00192-022-05184-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS An objective diagnostic method to understand vaginal laxity (VL) is still missing. The aim of our study is to determine whether vaginal wall thickness (VWT) measured by ultrasound may differ according to the abdominal or vaginal techniques and to assess whether clinical variables are associated with vaginal measurements of women with VL. METHODS A cross-sectional study conducted at a tertiary hospital included 82 women aged ≥ 18 years with VL complaints assessed by the Vaginal Laxity Questionnaire. Women who reported severe comorbidities or vulvovaginal disorders, previous treatment for VL, and use of vaginal estrogen in the last 6 months were excluded. Participants reporting VL underwent transabdominal (TAUS) and transvaginal ultrasound (TVUS) and physical examination and answered validated questionnaires. Descriptive data were given as mean and standard deviation, median (range), and absolute and relative frequency. The significance level adopted for this study was 5%. Sample size calculation was not performed for the present study. RESULTS Mean age was 41.20 ± 8.64 years, and most participants were multiparous, with previous vaginal delivery and having vaginal intercourse. A statistically significant difference (up to 3 mm) between TAUS and TVUS measurements of the VWT was found in the proximal, middle-third, and distal compartments. A significant correlation was found between VWT and TAUS or TVUS in the mid-third and distal compartments. CONCLUSION A significant correlation was found between the VWT measurements in TVUS and TAUS. Our findings might give the health professional more possibilities for investigating VWT according to patient characteristics.
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Affiliation(s)
- Glaucia Miranda Varella Pereira
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas-UNICAMP, Rua Alexander Fleming, 101-Cidade Universitária-Campinas, São Paulo, 13083-881, Brazil
| | - Cassia Raquel Teatin Juliato
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas-UNICAMP, Rua Alexander Fleming, 101-Cidade Universitária-Campinas, São Paulo, 13083-881, Brazil
| | - Cristiane Martins de Almeida
- Division of Imaging, Women's Hospital-Professor Doutor José Aristodemo Pinotti-CAISM-University of Campinas-UNICAMP, Campinas, Brazil
| | - Isabella Salvetti Valente
- Division of Imaging, Women's Hospital-Professor Doutor José Aristodemo Pinotti-CAISM-University of Campinas-UNICAMP, Campinas, Brazil
| | - Kleber Cursino de Andrade
- Division of Imaging, Women's Hospital-Professor Doutor José Aristodemo Pinotti-CAISM-University of Campinas-UNICAMP, Campinas, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas-UNICAMP, Rua Alexander Fleming, 101-Cidade Universitária-Campinas, São Paulo, 13083-881, Brazil.
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