Objective: To evaluate the effect of iatrogenic menopause on the
physiology of the vagina of the ewe, and to evaluate if vaginal changes
in ewes can be translated to women with the genitourinary syndrome of
menopause (GSM). Design: Animal study, randomised design for ovariectomy
or control, blinded for allocation and outcome assessment. Setting:
University of Cape Town, South Africa. Population or Sample: Twenty-five
Dohne Merino ewes. Methods: Iatrogenic menopause was induced in 20
animals by bilateral ovariectomy. Five animals served as a control group
(no intervention). Differences between groups were determined by linear
regression analyses (adjusted for baseline scores) at 5 months after
ovariectomy. Main Outcome Measures: Vaginal epithelial thickness, pH,
vaginal maturation value, vaginal maturation index, epithelial glycogen
accumulation, content of elastin fibres, collagen, and vascularity.
Results: Ovariectomised ewes showed epithelial thinning of the vaginal
wall from 146 µm to 47 µm (mean, p <0.001 ). In addition,
epithelial glycogen accumulation (43%) and the vascularity (23%) of
the vaginal wall significantly decreased as compared to the control
group. No differences were found for vaginal pH, vaginal cytology
outcomes, elastin fibres and collagen content. Conclusions: This study
established the ewe as a suitable large animal model for GSM.
Furthermore, the similar relevant outcomes in humans and ewes hold great
value for future translational research for the evaluation and
optimisation of different treatment modalities for GSM. Funding: None.
Keywords: Atrophy, ewe, genitourinary syndrome of menopause, model,
ovariectomy.
This retrospective review revealed the potentially beneficial effect of the large (180 ml × 2) bilateral SORI with retropubic TVT placement in terms of the reduction in risk of bladder perforation. It also showed no potential added risk of post-operative complications.
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