The electrovaginogram: study of the vaginal electric activity and its role in the sexual act and disorders

Objectives We investigated the hypothesis that the vagina generates electric waves which effect vaginal contraction during penile thrusting.Methods In 24 healthy female volunteers, the electric waves of the vagina were recorded by two electrodes applied to its wall. The vaginal pressure was registered by a manometric tube. The electric waves and vaginal pressure were recorded at rest and on vaginal distension by condom in increments of 10 ml of carbon dioxide. The test was repeated after vaginal anesthetization proximally and distally to the electrodes.Results Slow waves (SWs) were recorded from the two electrodes with regular rhythm and similar frequency, amplitude and conduction velocity. They were randomly followed or superimposed by action potentials (APs). Vaginal pressure increase was coupled with APs. Large-volume condom distension significantly increased the electric waves variables and pressure. Upon vaginal anesthetization, the electric waves were recorded proximal but not distal to the anesthetized area.Conclusions Electric waves could be recorded from the vagina. They spread caudad. A pacemaker was postulated to exist at the upper vagina evoking these waves. The electric waves seem to be responsible for the vaginal contractile activity. Large-volume vaginal distension effected an increase in the vaginal electric waves and pressure which probably denotes increased vaginal muscle contraction. It appears that penile thrusting during coitus stimulates the vaginal pacemaker which effects an increase in vaginal electric activity and muscle contractility and thus leading to an increase in sexual arousal. The vaginal pacemaker seems to represent the G spot, which is claimed to be a small area of erotic sensitivity in the vagina. The electrovaginogram may act as a diagnostic tool in the investigation of sexual disorders.     

Impact of the tension-free vaginal tape obturator procedure on sexual function in women with stress urinary incontinence

Objective

To evaluate prospectively the impact of the tension-free vaginal tape obturator (TVT-O) procedure on sexual function in women with stress urinary incontinence (SUI).

Methods

The present prospective study included women with SUI and no concomitant prolapse who underwent a TVT-O procedure at Fuzhou General Hospital in Fuzhou, Fujian, China. Before and 6 months after surgery, the patients had their sexual function evaluated using the Female Sexual Function Index (FSFI) questionnaire. Only sexually active women were included in the final analysis.

Results

Among the 55 sexually active patients, 21.8% had coital incontinence, which was cured in 11 of 12 patients (91.7%). More than half (54.5%) the women reported an improvement in sexual function after surgery and 45.5% reported no change. No statistically significant difference was found between preoperative and postoperative total or domain (desire, arousal, lubrication, orgasm, satisfaction, and pain) scores on the FSFI.

Conclusion

The TVT-O procedure in women with SUI did not significantly affect sexual function. Further studies are needed to verify the findings and compare the impact of TVT-O on sexual function with that of other anti-incontinence procedures.     

The short-term outcome of laser in the management of female pelvic floor disorders: Focus on stress urine incontinence and sexual dysfunction

Objective

Female pelvic floor disorders, including female stress urinary incontinence (SUI) or sexual dysfunction are notorious for affecting the quality of women's life. It is reported that laser therapy might result in collagen remodeling and improvement in tissue firmness. The study was conducted to evaluate the short-term outcome of female pelvic floor disorders treated by laser therapy.

葛根对盆底功能障碍性疾病患者阴道壁组织MMP-1及其抑制物表达的影响

目的探讨中药葛根对盆底功能障碍性疾病患者阴道壁结缔组织中基质金属蛋白酶-1（MMP-1）和基质金属蛋白酶组织抑制物-1（TIMtX-1）mRNA表达的影响。方法将2009年12月至2011年11月上海嘉定安亭医院及交通大学医学院附属仁济医院妇科收治的60例Ⅲ期子宫脱垂及阴道前后壁脱垂的绝经患者分为葛根组（30例,术前给予葛根连续治疗30d）和对照组（30例,未使用任何外源性雌激素）,采用反转录-聚合酶链反应分别检测阴道壁组织中MMP-1和TIMP-1mRNA的表达。结果葛根组MMP-1表达量（23．65±2．41）较对照组（32．07±4．31）显著下降（P〈0．05）,而葛根组TIMP-1表达量（29．38±2．3）与对照组（29．86±1．81）比较,差异无统计学意义（P〉0．05）,两组MMP-1／TIMP-1值比较,差异有统计学意义（P〈0．05）。结论中药葛根明显降低阴道壁结缔组织中MMP-1的表达,MMP-1／TIMP-1值降低,使胶原蛋白降解减少,从而增加了胶原蛋白的含量。