Observational cohort study of the effect of a single lubricant exposure during transvaginal ultrasound on cell-shedding from the vaginal epithelium
AuthorO'Hanlon, D Elizabeth
Brown, Sarah E
Stennett, Christina A
Robbins, Sarah J
Johnston, Elizabeth D
Wnorowski, Amelia M
Cone, Richard A
Brotman, Rebecca M
PublisherPublic Library of Science
MetadataShow full item record
AbstractThe outer layers of the vaginal epithelium (VE) are important because they accumulate glycogen which, under optimal conditions, Lactobacillus spp. consume to grow and acidify the vaginal microenvironment with lactic acid. We hypothesized that exposure to lubricant, for example in the conduct of a transvaginal ultrasound (TVUS), may contribute to the shedding of mature epithelial cells, exposing immature cells. Cervicovaginal fluid (CVF) was sampled at four time points by menstrual cup (Softdisc™) from 50 women referred for TVUS, during which a controlled volume of lubricant was applied to the TVUS wand. Samples were collected (1) immediately before TVUS and (2) 6-12 hours, (3) within one week, and (4) two weeks after TVUS. Clinical vaginal lubricants are similar to commercial lubricants, and often have a high osmolality or pH, and contain bactericides such as methylparaben and propylparaben. The number and maturity of epithelial cells in each CVF sample were measured by quantitative and differential fluorimetry (maturity index, MI). Comparisons of cell-counts and maturity were made by paired Wilcoxon signed-rank tests. Among women with a high pre-TVUS MI (> 3), there was a decrease in median cell-count and mean MI in the sample collected 6-12 hours after TVUS (p<0.001, n = 26 and p < 0.001, n = 26, respectively). For these women, cell-count and MI remained lower in the sample collected within the subsequent week (p<0.001, n = 29 and p<0.01, n = 29, respectively), and MI remained lower in the sample collected within two weeks of TVUS (p<0.01, n = 25), compared to the pre-TVUS sample. Among participants with a low pre-TVUS MI (< 3), cell-count was higher in the sample collected within two weeks of TVUS compared to the pre-TVUS sample (p = 0.03, n = 15), but no significant changes in MI were observed. Results were similar when restricted to reproductive-age women. This preliminary data indicates hypertonic vaginal lubricants may increase vaginal epithelial cell shedding.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/15584
- Methods for assessing pre-induction cervical ripening.
- Authors: Ezebialu IU, Eke AC, Eleje GU, Nwachukwu CE
- Issue date: 2015 Jun 12
- Imaging modalities for the non-invasive diagnosis of endometriosis.
- Authors: Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML
- Issue date: 2016 Feb 26
- Comparison Between 360° 3-D Transvaginal Ultrasound and Magnetic Resonance Imaging for Assessment of Vaginal Invasion in Cervical Cancer: A Preliminary Report.
- Authors: Zhu Y, Lu M, Dai KJ, Liu C, He R
- Issue date: 2021 May 18
- Combination of the non-invasive tests for the diagnosis of endometriosis.
- Authors: Nisenblat V, Prentice L, Bossuyt PM, Farquhar C, Hull ML, Johnson N
- Issue date: 2016 Jul 13
- Endometrium segmentation on transvaginal ultrasound image using key-point discriminator.
- Authors: Park H, Lee HJ, Kim HG, Ro YM, Shin D, Lee SR, Kim SH, Kong M
- Issue date: 2019 Sep