Assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy

ABSTRACT

The objective of this review is to provide an overview of existing and evolving methods of assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy A systematic literature search was carried out on MEDLINE and Embase in order to identify studies on diagnostic instruments for vulvar, vaginal, and lower urinary tract atrophy, as well as new possibilities allowing for an improved diagnostic future. Measurement of the most bothersome symptoms, especially dyspareunia and vaginal dryness, is possibly the most useful parameter in clinical practice, even though it is a subjective measurement. Regarding objective result measurements, the two main parameters to be studied are the vaginal maturation index and vaginal pH measurement. In addition, clinical exploration has value both with the vaginal health index and with the vulvar health index. Other research tools are arising, such as a broader knowledge of the vaginal lamina propria elements, the measurement of vaginal distension, and the possibilities of having vaginal tissue ‘on a chip’. Gynecologists can make a diagnosis based on the patient’s symptoms and a thorough physical examination. However, in cases in which you want to be sure of the diagnosis, and when you want to evaluate and compare treatment options, we need to assess the associated symptoms, vaginal maturation index, and vaginal pH with a clinical estimation by the physician. However, there is an increasing need for new objective parameters helping in the evaluation process.

摘要

本综述的目的是概述评估症状性外阴、阴道和下尿路萎缩的现有和不断发展的方法。对MEDLINE和Embase进行了系统的文献检索, 以确定外阴、阴道和下尿路萎缩诊断工具的研究, 以及新的可能性, 以改善未来的诊断。评估最令人烦恼的症状, 尤其是性交困难和阴道干燥, 可能是临床实践中最有用的参数, 即使它是一种主观评估。关于客观结果测量, 要研究的两个主要参数是阴道成熟指数和阴道pH测量。此外, 临床评估对阴道健康指数和外阴健康指数都有价值。其他研究工具正在出现, 例如对阴道固有层成分的更广泛了解, 阴道扩张的测量以及阴道组织“在芯片上”的可能性。妇科医生可以根据患者的症状和全面的体检进行诊断。但是, 如果您想确定诊断, 并且想要评估和比较治疗方案, 我们需要通过医生的临床检查来评估相关症状、阴道成熟指数和阴道pH值。但是, 越来越需要新的客观参数来帮助评估过程。

KEYWORDS:

• Vulvar
• vaginal
• lower urinary tract
• atrophy
• evaluation
• lamina propria

Potential conflict of interest

No potential conflict of interest was reported by the author.

Source of funding

Nil.