Ultrasonographic measurement of vaginal thickness: Relation to menopausal status and genitourinary syndrome of menopause

Abstract

Objective: To compare the total vaginal wall thickness (TVT) and total mucosal thickness (TMT) measurements of premenopausal and postmenopausal women measured by ultrasonography and to determine the association of these measurements to findings and symptoms of genitourinary syndrome of menopause Methods: Healthy volunteers, 80 postmenopausal and 80 premenopausal, were included. Ultrasonographic TVT and TMT measurements, vaginal health index (VHI) scores and pH values were recorded. The daily impact of vaginal aging (DIVA) scale was administered to women in the postmenopausal group. Results: TVT measurements of the postmenopausal group (6.55 AE 2.00 mm) were lower than the premenopausal group (10.37 AE 2.11 mm) (p: 0.000). TMT measurements of the postmenopausal group (1.46 AE 0.50 mm) were lower than the premenopausal group (2.19 AE 0.60 mm) (p: 0.000). The VHI scores of the postmenopausal group were significantly lower than the premenopausal group, the pH value was higher (p < 0.05). Considering all women TVT and TMT measurements were inversely correlated with pH values and positively correlated with total VHI scores. There was no significant correlation between any component scores of the DIVA scale and TVT, TMT, pH, and VHI total (p > 0.05). Conclusions: TVT and TMT measurements in postmenopausal women are significantly lower than premenopausal women. Examination findings and thickness measurements are correlated. Transabdominal ultrasonography is a method that can be used in the evaluation of vaginal thickness which is not painful for the patient, is easy to apply and gives results consistent with the examination findings. However, measurements and examination findings do not correlate with the DIVA scores in postmenopausal women.

Vaginal wall thickness as potential biomarker of vaginal health. A proposal for standardized ultrasound measurement using three‐dimensional transvaginal ultrasound

“…Some authors have advocated measuring the total vaginal wall thickness using transabdominal ultrasound in the sagittal plane using a full bladder approach. [5][6][7] The potential limitation of this approach is that full bladder distension could affect vaginal wall thickness by provoking an artificial thinning and due to lower resolution compared to the transvaginal route, it could be difficult to differentiate the bladder wall from the vaginal wall. Furthermore, no studies assessing the repeatability of this measurement have been reported.…”

“…As vaginal wall thinning is a real phenomenon in the GSM, ultrasound measurement of vaginal wall thickness has been proposed as a potential biomarker of vaginal health. In fact, some authors have advocated this measurement using ultrasound 5–11 . However, we observed that there is no standardized approach for measuring vaginal wall thickness.…”

“…In fact, some authors have advocated this measurement using ultrasound. [5][6][7][8][9][10][11] However, we observed that there is no standardized approach for measuring vaginal wall thickness. For this reason, in the present manuscript, we aimed to propose a standardized method using three-dimensional (3D) ultrasound for measuring vaginal wall thickness by ultrasound as well as assessing the reproducibility of this measurement.…”

A Novel Method for the Measurement of the Vaginal Wall Thickness by Transvaginal Ultrasound: A Study of Inter- and Intra-Observer Reliability

“…In this manuscript, we aimed to evaluate a novel methodology for the measurement of vaginal wall thickness utilizing a transvaginal biplanar ultrasound probe. For the measurement of vaginal wall thickness (VWT), various ultrasound techniques have been proposed in the literature [ 3 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], both transabdominal and transvaginal and both 2D and 3D at high frequency. Panayi first described a transvaginal US technique to measure the thickness of the vaginal wall at various anatomical sites, including the bladder neck, anterior and posterior fornix, and rectum [ 21 ].…”