{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:29:40Z","timestamp":1782516580604,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute of Health Research, UK","doi-asserted-by":"crossref","award":["DRF-2015-08 to 217"],"award-info":[{"award-number":["DRF-2015-08 to 217"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Women with pelvic organ prolapse describe vaginal laxity and poor sensation of vaginal tone that does not correlate with anatomical findings. This discrepancy could be explained by altered vaginal sensation and a test that could measure sensation of vaginal tone, transmitted via A\u03b1 and A\u03b2 nerve fibers, would further our understanding of the pathophysiology of vaginal laxity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop quantitative sensory testing (QST) for vaginal tone using genital stretch perception thresholds (PT), assess reproducibility, and the association with age and parity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational cohort study of healthy women (Canadian task force classification II\u20102) who underwent QST method of limits at the vagina and introitus for sensation of first awareness and stretch using a modified anorectal physiology protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty women underwent repeatability testing. Intra\u2010 and inter\u2010rater repeatability using intraclass correlation coefficients (ICC) was good to excellent for both first awareness and stretch at the vagina and introitus (intra\u2010rater ICC\u2009=\u20090.93, 0.95, 0.81, and 0.88, respectively; inter\u2010rater ICC\u2009=\u20090.83, 0.93, 0.71, and 0.86 respectively).<\/jats:p><jats:p>Normative data were collected from 100 women. Log\u2010linear regression found a significant association between age and PT for first awareness and stretch at the vagina and introitus (<jats:italic>P\u2009<\/jats:italic>=\u2009.020, .008, .002, and &lt;.001, respectively). There was no association with parity and PT. Nomograms were calculated using the 95% confidence limits around the regression line.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Stretch QST is clinically feasible, valid, and reproducible. The test can be used as a tool to measure sensation in women presenting with symptoms of vaginal laxity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24282","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T20:28:28Z","timestamp":1579638508000},"page":"778-784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Method of limits: Female genital stretch perception thresholds"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2449-6138","authenticated-orcid":false,"given":"Charlotte","family":"Mahoney","sequence":"first","affiliation":[{"name":"Department of Urogynaecology, The Warrell Unit, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"},{"name":"Materno\u2010Fetal Health Research Group, Faculty of Medical and Human Sciences, Institute of Human Development University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sok\u2010Moi","family":"Chok","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Division, Lancashire Women and Newborn Centre, Burnley General Hospital East Lancashire NHS Trust Burnley UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Bryant","sequence":"additional","affiliation":[{"name":"Department of Urogynaecology, The Warrell Unit, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Myers","sequence":"additional","affiliation":[{"name":"Materno\u2010Fetal Health Research Group, Faculty of Medical and Human Sciences, Institute of Human Development University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Urogynaecology, The Warrell Unit, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Urogynaecology, The Warrell Unit, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,21]]},"reference":[{"issue":"6","key":"e_1_2_9_2_1","first-page":"839","article-title":"The relationship between age & the impact of pelvic floor symptoms: \u201cThe 4,000 women study","volume":"9","author":"Dua A","year":"2010","journal-title":"Int Urogynecol J"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.119078"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12083"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2637-5"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.984"},{"key":"e_1_2_9_7_1","volume-title":"Ganong's Review of Medical Physiology","author":"Barrett K","year":"2012"},{"issue":"4","key":"e_1_2_9_8_1","first-page":"382","article-title":"Innervation of the human vulva and vagina: a microscopic study","volume":"12","author":"Krantz K","year":"1958","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000147722"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.39.11.1071"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/41.6.732"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1987.tb03583.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnp.2018.06.004"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2014.09.017"},{"key":"e_1_2_9_15_1","unstructured":"Laerd Statistics.Simple Linear Regression: Dealing With Outliers. p. 14 2017."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.86.2.420"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.10.024"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(00)00850-5"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199803)21:3<367::AID-MUS11>3.0.CO;2-X"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(94)90239-9"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.42.9.793"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0892-0362(94)90015-9"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2000.00026.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00838158"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.29.1.38"},{"key":"e_1_2_9_27_1","first-page":"232","volume-title":"Studies on Neuromuscular Diseases","author":"Drechsler F","year":"1975"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2018.27"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90620-G"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0657-4"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del022"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fnau.24282","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.24282","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.24282","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.24282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T01:41:36Z","timestamp":1693618896000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.24282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,21]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1002\/nau.24282"],"URL":"https:\/\/doi.org\/10.1002\/nau.24282","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,21]]},"assertion":[{"value":"2019-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}