Description of Vaginal Laxity and Prolapse and Correlation With Sexual Function (DeVeLoPS)

Area of Science:

• Urology
• Gynecology
• Sexual Medicine

Background:

• Vaginal laxity (VL) is a common sensation of vaginal looseness, often associated with childbirth, aging, and menopause.
• Pelvic organ prolapse (POP) involves the descent of pelvic organs and may coexist with VL.
• Emerging energy-based treatments have increased interest in understanding and managing VL.

Purpose of the Study:

• To investigate the correlation between subjective symptoms of vaginal laxity (VL) and objective physical examination findings of pelvic organ prolapse (POP).
• Specifically, to assess the relationship between VL symptoms and the introital measurement of genital hiatus.

Main Methods:

• A multi-center, cross-sectional study included 95 sexually active women over 18 with at least one prior delivery.
• Participants completed validated questionnaires: Vaginal Laxity Questionnaire (VLQ), Pelvic Floor Distress Inventory-20, and Female Sexual Function Index (FSFI).
• Pelvic examinations included the Pelvic Organ Prolapse Quantification (POP-Q) system to measure prolapse severity and genital hiatus.

Main Results:

• No significant correlation was found between Vaginal Laxity Questionnaire (VLQ) scores and Pelvic Organ Prolapse (POP) measurements or mid-vaginal caliber.
• Vaginal tightness sensation was significantly associated with older age and postmenopausal status.
• Only 28% of sexual partners commented on laxity, with most noting tightness (21%) rather than looseness (7%).

Conclusions:

• Vaginal laxity (VL) symptoms are not significantly correlated with objective physical findings of pelvic organ prolapse (POP) or measures of sexual function.
• This study highlights the need for a more standardized definition of vaginal laxity.
• Development of improved assessment tools for vaginal laxity symptoms is crucial for clinical evaluation and treatment.