Is vaginal laxity an early symptom of pelvic organ prolapse?

Alexander, J.; Gillor, Moshe; Dietz, Hans Peter

doi:10.1007/s00192-021-04927-3

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…Medical interviews were chosen as a method to diagnose or evaluate VL in 19 studies, which involved 4,409 subjects ( Table 3 ). 5 45 46 47 48 53 54 55 56 57 58 59 60 61 62 63 64 65 66 Eleven studies made a diagnosis effort of VL using interviews only. 46 47 53 54 55 57 58 59 60 61 63 Four studies chose interviews in combination with other measurement options, 48 56 62 65 and one study added the VL degree of bother evaluation.…”

Section: Resultsmentioning

confidence: 99%

“…Other evaluations reported in the included studies, such as vaginal tactile imaging (VTI), 71 vaginal biomechanic analyzer (VBA), 72 four-dimensional translabial ultrasonography (4D-TLUS), 5 32 46 54 55 surface electromyography (sEMG), 59 vaginal health index, 53 71 and other histological assessment, 68 are presented in Table 6 .…”

Section: Resultsmentioning

confidence: 99%

“…Medical interviews were chosen as a method to diagnose or evaluate VL in 19 studies, which involved 4,409 subjects (Table 3). [5,[45][46][47][48][53][54][55][56][57][58][59][60][61][62][63][64][65][66] Eleven studies made a diagnosis effort of VL using interviews only [46,47,[53][54][55][57][58][59][60][61]63] Four studies chose interviews in combination with other measurement options, [48,56,62,65] and one study added the VL degree of bother evaluation. [5] Four studies reported treatment evaluation by conducting interviews.…”

Section: Medical Interviewsmentioning

confidence: 99%

“…[75] Another imaging device, 4D-TLUS, is used to record and assess the topography of the pelvis and vagina, therefore diagnosing levator avulsion and hyperdistension. [32,46,54,55] Photograph evaluation was used by Mortiers et al and Mitsyuki et al in their studies to evaluate vaginal introitus through visual inspection. [50,51] Diagnosing VL using photographs, as described by Mortiers et al [50] is reliable, reproducible, and valid.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Current Perspectives in Vaginal Laxity Measurement: A Scoping Review

Aulia

Valeria

2023

Arch Plast Surg

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This scoping review aimed to identify and categorize the available measurement options for vaginal laxity (VL) their indications of use, and whether these measurements can sufficiently provide objective clinical judgment for cases indicated for vaginal rejuvenation with many treatment options nowadays. Systematic searches were conducted on five electronic databases, manually searching articles’ bibliographies and predetermined key journals with no date or study design limitations. We included all studies involving VL in their inclusion criteria, treatment indications, and outcome parameters. We used the Arksey and O’Malley frameworks as the guideline in writing this scoping review. Of the 9,464 articles identified, 66 articles and 11,258 subjects were included in the final analysis. The majority of studies were conducted in obstetrics and gynecology (73%), followed by plastic surgery (10%), medical rehabilitation (4.5%), dermatology (4.5%), and others (8%). Most studies originated from the North American region (30%). The following measurement tools were used: (1) interviews, (2) questionnaires, (3) physical/digital examinations, (4) perineometers, and (5) others. Our results suggested that subjective perception of laxity confirmed by directed interview or questionnaire is sufficient to confirm VL. Additional evaluation of PFM through digital examination or perineometer or other preferred tools and evaluation of sexual function through validated questionnaire (FSFI, FSDS-R, etc) should follow to ensure holistic care to patients. Future research on the psychometric properties (reliability and validity) of commonly used measurements and the correlation in between subjective and objective measurements should be initiated before their clinical applications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Medical Interviewsmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

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Current Perspectives in Vaginal Laxity Measurement: A Scoping Review

Aulia

Valeria

2023

Arch Plast Surg

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“…There is an extraordinarily strong association with musculus levator ani extensive distensibility and all measures of anterior and posterior compartment descent [7]. However, it is not an early symptom of pelvic organ prolapse [8].…”

Section: Of 12mentioning

confidence: 99%

Treatment of Vulvovaginal Laxity by Electroporation: The Jett Plasma Medical for Her II Study

Fait,

Baltazár,

Bubenickova

et al. 2023

JCM

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Introduction: Vaginal laxity is a widespread and undertreated medical condition associated especially with vaginal parity. Aim: To evaluate the efficacy and safety of electroporation therapy treatment of vulvovaginal laxity by the Jett Plasma for Her II device. Methods: The Jett Plasma for Her II Study is a multicentric, prospective, randomized, single-blinded, and controlled study. Women presenting with vaginal laxity were randomized to receive electroporation therapy delivered to the vaginal tissue (active—82 patients) vs. therapy with zero intensity (placebo—9 patients). Results: A total of 91 subjects whose average age was 48.69 ± 10.89 were included. Due to the results of a one-way analysis of variance, it may be concluded that in the case of the vaginal laxity questionnaire (VLQ), there is a statistically significant difference between actively treated patients and the placebo group (F1,574 = 46.91; p < 0.001). In the case of the female sexual function index (FSFI), a one-way ANOVA test also showed a statistically significant difference between the actively treated patients and the placebo group (F1,278 = 7.97; p = 0.005). In the case of the incontinence impact questionnaire-7 (IIQ-7), a one-way ANOVA test showed a statistically significant difference between the actively treated patients and the placebo group (F1,384 = 15.51; p < 0.001). It confirms that improvement of vaginal laxity is conjoined with benefits in symptoms of urinary incontinence. Biopsy performed after the end of the treatment shows an increase in the vaginal mucosa thickness by an average of 100.04% in the active group. The treatment was well tolerated with no adverse events. No topical anesthetics were required. Conclusions: Treatments of vulvovaginal laxity by electroporation therapy achieved significant and sustainable 12-month effectiveness. Responses to the questionnaires also suggest subjective improvement in self-reported sexual function, incontinence, sexual satisfaction, and urogenital distress.

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Is Vaginal Laxity Associated with Vaginal Parity and Mode of Delivery?

Mustafa-Mikhail,

Gillor,

Francis

et al. 2024

Int Urogynecol J

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Introduction and Hypothesis Vaginal laxity (VL) is a common symptom of pelvic floor dysfunction. Although VL has become a frequent topic for research in the last decade, its pathogenesis is still not well understood. The objective was to determine whether vaginal parity or mode of delivery is associated with vaginal laxity. Methods This was a retrospective observational study involving women seen in a tertiary urogynecology clinic between May 2016 and November 2018 with symptoms of pelvic floor dysfunction. Patients underwent a standardized interview, clinical examination (POP-Q), and four-dimensional (4D) pelvic floor ultrasound (PFUS). Data regarding vaginal parity and the mode of delivery were based on patient-reported information. Archived 4D-PFUS volumes were analyzed offline to evaluate levator hiatal area on Valsalva. Results Data from 1,051 patients were analyzed. VL was reported by 236 women (23%) who were younger on average (mean age 54 vs 59 years, p < 0.001) and less likely to be menopausal (530 out of 815 [65.0%] vs.129 out of 236 [54.7%]), p = 0.004]. Symptoms of prolapse were much more common in the VL group (214 out of 236 [91%] vs 316 out of 815 [39%], p = < 0.001) and on imaging mean levator hiatal area (HA) on Valsalva was larger (31 vs 26 cm2, p = 0.01). Vaginal parity was associated with VL symptoms (235 out of 236 [99%] vs 767 out of 815 [94%], p = 0.008), but neither VL prevalence nor bother increased with higher parity. Women who delivered vaginally were three times more likely to complain of VL than those who delivered only by cesarean section. Conclusions Vaginal laxity was found to be more prevalent in vaginally parous women. This effect seems to be largely attributable to the first delivery. Instrumental delivery was not shown to increase association with VL compared with normal vaginal delivery.

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Is vaginal laxity an early symptom of pelvic organ prolapse?

Cited by 7 publications

References 15 publications

Current Perspectives in Vaginal Laxity Measurement: A Scoping Review

Current Perspectives in Vaginal Laxity Measurement: A Scoping Review

Treatment of Vulvovaginal Laxity by Electroporation: The Jett Plasma Medical for Her II Study

Is Vaginal Laxity Associated with Vaginal Parity and Mode of Delivery?

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