The vaginal pressure profile.
OBJECTIVE
To describe the vaginal pressure profile in asymptomatic nulliparous women.


METHODS
Fourteen nulliparous women without symptoms of anal or urinary incontinence were studied with vaginal manometry. A rapid pull-through technique utilized a four-channel water-perfused catheter on a motor-driven puller to create a pressure profile for each subject. The profiles were measured with the subject at rest and during a sustained contraction of the levator ani muscle. The individual subject's pressure profiles were averaged to create a composite profile at rest and during squeeze.


RESULTS
The vaginal pressure profile at rest and during squeeze contains three pressure zones: proximal, mid, and distal. The pressure is highest in the mid pressure zone and was labeled as the vaginal high-pressure zone. In the vaginal high-pressure zone, the maximum pressure during squeeze is significantly higher than the maximum pressure at rest (P < 0.05). The length of the high-pressure zone is longer during squeeze as compared to rest (P < 0.05). The maximum pressures exhibit circumferential asymmetry with the pressures in anterior and posterior directions being significantly higher than those in the lateral directions (P < 0.05).


CONCLUSIONS
The vaginal pressure profile is more complex than previously described. Understanding of the vaginal pressure profile is crucial when employing vaginal manometry to assess pelvic floor muscle strength or as a surrogate for intra-abdominal pressure.
Guaderrama
Noelani M
NM
Department of Reproductive Medicine, Internal Medicine and Radiology, Division of Female Pelvic Medicine and Reconstructive Surgery, The Pelvic Floor Function and Disorder Group, University of California, San Diego, California 92037, USA.
Nager
Charles W
CW
Liu
Jianmin
J
Pretorius
Dolores H
DH
Mittal
Ravinder K
RK
D000328:Adult; D005260:Female; D006801:Humans; D008365:Manometry / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D010298:Parity; D017773:Pelvic Floor / Q000502:physiology; D011312:Pressure; D012016:Reference Values; D012146:Rest / Q000502:physiology; D014621:Vagina / Q000502:physiology*