Validation of a clinical tool for vestibular trophism in postmenopausal women

Abstract

Objective

This study aimed to develop and validate a clinical tool to assess vestibular trophism in women with genitourinary syndrome of menopause (GSM).

Methods

In this cross-sectional study, the principal investigator’s center and three external reviewers assessed the vestibular images of postmenopausal women using a multi-item tool defined as vestibular trophic health (VeTH), which assessed five criteria: petechiae, pallor, thinning, dryness and redness. Dryness, dyspareunia, vulvar pain and the Vaginal Health Index (VHI) were also evaluated.

Results

Analysis of the intraclass correlation coefficient (0.76; confidence interval 0.62–0.82) and Cronbach’s alpha coefficient (0.78; confidence interval 0.64) indicated an inter-rater reliability and reproducibility of VeTH in the 70 women enrolled in the study. The observed covariance between a high VeTH score and the symptom severity demonstrated a significant correlation, which was not evident between VeTH and the total VHI score.

Conclusions

The vulvar vestibule is the main location of genital tenderness, primarily responsible for burning/pain and entry dyspareunia because of its capacity to develop an excess of nociceptors upon sexual hormone deprivation. Our study indicated that VeTH can be a reproducible tool for the morphological classification of vestibular trophism and bears a significant correlation with the severity of the symptoms.

摘要

目的：本研究旨在开发和验证一种评估绝经期泌尿生殖综合征（GSM）女性前庭营养状况的临床工具。

方法：在这项横断面研究中, 主要研究者所在的中心和三名外部评审员使用定义为前庭营养健康（VeTH）的多项目工具评估了绝经后妇女的前庭图像, 该工具评估有五个标准：瘀斑、苍白、变薄、干燥和红肿。还评估了干燥、排尿困难、外阴疼痛和阴道健康指数（VHI）。

结果：组内相关系数(0.76; 置信区间 0.62–0.82)和克伦巴赫alpha系数(0.78; 置信区间 0.64)的分析表明, 在参加研究的70名妇女中, VeTH具有评分者间的可靠性和可重复性。观察到VeTH高分与症状严重程度之间的协方差显示出明显的相关性, 而VeTH与VHI总分之间则没有明显的相关性。

结果：外阴前庭是生殖器触痛的主要部位, 会导致烧灼/疼痛和性交疼痛, 因为它在性激素缺乏时会产生过量的神经感受器。我们的研究表明, VeTH可以作为前庭营养状况分类的一个可重复的工具, 并与症状的严重程度有明显的相关性。

Keywords:

• Dyspareunia
• vulvar pain
• Vaginal Health Index
• vulval vestibule
• sexual hormone deprivation
• vestibulodynia

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Source of funding

Nil.