Vaginal introital laxity
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| Vaginal laxity |
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Vaginal laxity is a symptom of pelvic floor dysfunction characterised by a sensation of looseness of the vagina.[citation needed]
Signs and symptoms
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Pathophysiology
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Diagnosis
[edit]Physical examination
[edit]Healthcare providers will perform pelvic examinations to assess the vaginal tissue.[1] Patients are first asked to empty their bladders to improve access to the pelvic organs, and to alleviate any discomfort or pressure that may arise from a full bladder during the examination.[1] They are then placed in a supine position, usually lying on their back on birthing chairs at 45 degrees with their feet in stirrups, allowing the legs to be comfortably positioned.[2] This position is called the dorsal lithotomy position, which is most commonly used in genital examination.[2] In some cases, alternative positions such as the supine frog leg position or the prone knee chest position may be used.[3] The speculum is available in different sizes and shapes to accommodate individual anatomy.[4]
Moreover, pelvic floor assessment may be used to evaluate the strength and tone of the muscles.[5] This may involve requesting patients to perform specific movements, such as contracting and relaxing the pelvic floor muscles, coughing, or bearing down.[5] This helps evaluate the muscle function and identify any issues or weaknesses.[5]
Vaginal laxity questionnaire
[edit]A vaginal laxity questionnaire (VLQ) is designed to evaluate the degree of perceived vaginal looseness.[6] The questionnaire covers several aspects:[6]
- Physical symptoms: sensations of looseness, lack of tightness, or reduced friction during sexual intercourse
- Sexual function: changes in sexual satisfaction, orgasmic intensity, or sexual desire due to vaginal laxity
- Impact on quality of life: impact of vaginal laxity on self-esteem, body image, and overall well-being
- Emotional well-being: feelings of embarrassment, discomfort, or distress related to vaginal introital laxity
Sexual satisfaction questionnaire
[edit]A sexual satisfaction questionnaire (SSQ) is used to assess sexual quality of life and sexual function.[7]
Treatment
[edit]The United States Food and Drug Administration has issued a warning against the use of energy-based (laser and radiofrequency) devices to treat vaginal laxity, as its safety and efficacy need further investigation.[8] Laser and radiofrequency treatments do not improve sexual function,[6] and vaginal tightening does not increase sensation.[6] Pelvic floor muscle strength was improved after treatment.[6]
References
[edit]- ^ a b Haylen, Bernard T. (2007). "The empty bladder". International Urogynecology Journal and Pelvic Floor Dysfunction. 18 (3): 237–239. doi:10.1007/s00192-006-0111-0. PMID 16791705.
- ^ a b Barber, Matthew D.; Lambers, Anouk R.; Visco, Anthony G.; Bump, Richard C. (2000). "Effect of Patient Position on Clinical Evaluation of Pelvic Organ Prolapse". Obstetrics & Gynecology. 96 (1): 18–22. doi:10.1016/s0029-7844(00)00859-0. ISSN 0029-7844. PMID 10862835.
- ^ Goldberg, Murray G.; Surya, Babu V.; Catanese, Anthony; Johanson, Karl-Eric; Brown, Jordan (1991-11-01). "Effect of Patient Positioning on Urethral Mobility: Implications for Radical Pelvic Surgery". The Journal of Urology. 146 (5): 1252–1254. doi:10.1016/S0022-5347(17)38061-8. ISSN 0022-5347. PMID 1942273.
- ^ Evans, Devon; Goldstein, Susan; Loewy, Amanda; Altman, Alon D. (2019-08-01). "No. 385-Indications for Pelvic Examination". Journal of Obstetrics and Gynaecology Canada. 41 (8): 1221–1234. doi:10.1016/j.jogc.2018.12.007. ISSN 1701-2163. PMID 31331610.
- ^ a b c Dietz, Hans Peter (2009). "Pelvic Floor Assessment". Fetal and Maternal Medicine Review. 20 (1): 49–66. doi:10.1017/S096553950900237X. ISSN 1469-5065.
- ^ a b c d e Pereira, Glaucia Miranda Varella; Cartwright, Rufus; Juliato, Cássia Raquel Teatin; Domoney, Claudine; Iglesia, Cheryl B; Brito, Luiz Gustavo Oliveira (2024-04-30). "Treatment of women with vaginal laxity: systematic review with meta-analysis". The Journal of Sexual Medicine. 21 (5): 430–442. doi:10.1093/jsxmed/qdae028. ISSN 1743-6095.
- ^ FU, Lixia; Long, Senyang; LI, Qin; XU, Hainan; Guo, Ling; Wang, Huarong; Zheng, Zhongyan; Zhang, Jing (2023-03-23). "The efficacy and safety of temperature controlled dual-mode radiofrequency in women with vaginal laxity". BMC Women's Health. 23 (1): 121. doi:10.1186/s12905-023-02261-y. ISSN 1472-6874. PMC 10035145. PMID 36959573.
- ^ Shobeiri, S. Abbas; Kerkhof, M. H.; Minassian, Vatche A.; Bazi, Tony; on behalf of the IUGA Research and Development Committee (2019-03-01). "IUGA committee opinion: laser-based vaginal devices for treatment of stress urinary incontinence, genitourinary syndrome of menopause, and vaginal laxity". International Urogynecology Journal. 30 (3): 371–376. doi:10.1007/s00192-018-3830-0. ISSN 1433-3023. PMID 30523374.