摘要

Objectives: The aim of the study was to investigate the effect of multifractional intercalated hyaluronic acid (MIC-HA) injection on anterior and posterior vaginal wall thickness (VWT) using 3D-high frequency endovaginal ultrasound (3D-EVUS), and also to assess the relationship between sexual functions and VWT increase in women with genitourinary syndrome of menopause (GSM) after the injection. Introduction: There are many studies reported short-term improving effects of topical HA on GSM symptoms and have used subjective assessment tools. However, there are no studies assessing the effect of injectable hyaluronic acid on the VWT ultrasonographically in women with GSM. Materials / method: Thirty-one women with GSM were enrolled the study. After local anesthetic injection, 2 ml of MIC-HA was injected into the vaginal wall with a standardized injection technique. The vaginal health index (VHI), Turkish validated form of the Female Sexual Function Index (FSFI), anterior and posterior VWT measurements by 3D-EVUS were recorded before and 4 weeks after intervention. Results: Four weeks after MIC-HA injection, VHI scores and total FSFI scores including all sub-scores were significantly higher than the baseline scores. Post-injection measurements of anterior and posterior VWT were found to be significantly increased compared with pre-injection VWT measurements (p=0.0001 and p=0.0001, respectively). While there was a positive correlation between increase rates of posterior VWT and satisfaction sub-score (r=0.436. p=0.014), desire and arousal sub-scores were positively correlated with increase rates of anterior VWT (r=0.357, p=0.038; r=0.389, p=0.031, respectively). Conclusion: Measurement of anterior and posterior VWT with 3D-HFUS showed objective improvement in GSM symptoms after vaginal MIC-HA injection. The relationship between different components of sexual function and the increase in anterior and posterior VWT will provide a different perspective on the complexity of sexual function.