{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:25:01Z","timestamp":1774437901148,"version":"3.50.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":691,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Associazione Italiana Vulvodinia"}],"content-domain":{"domain":["smoa.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>A multifactorial etiology has been implicated in the development and maintenance of vestibulodynia (VBD), and atrophic changes of the vestibular mucosa have been observed in many patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To assess the vestibular mucosa thickness in patients with VBD by comparing this sample with a control group of healthy fertile women and postmenopausal patients with symptoms of genitourinary syndrome of menopause (GSM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Vestibular mucosa thickness was measured with a 20\u00a0MHz ultrasound probe (DermaScan C, Cortex Technology, Denmark), including both the epidermis and dermis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>All women were evaluated by anamnesis, physical examination, and self-report symptoms. Thickness of the vestibular mucosa (expressed in micrometers) was determined by the B-mode, excluding the hyperechogenic entrance echo and hypoechogenic subcutis. Clinical data related to VBD and GSM were recorded using a 0- to 10-point visual analog scale related to dyspareunia and vulvar pain\/burning (0\u00a0=\u00a0no pain; 10\u00a0=\u00a0worst possible pain).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 85 patients were recruited: 24 with VBD, 20 with GSM-related symptoms, and 20 matched controls. Vestibular mucosa thickness measurements were not significantly different between the VBD (mean\u00a0\u00b1\u00a0DS: 1,092.5\u00a0\u00b1\u00a0226.1\u00a0\u03bcm) and GSM groups (1,059.7\u00a0\u00b1\u00a0221.5\u00a0\u03bcm), while the parameter was significantly lower (P\u00a0&amp;lt;\u00a0.01) than the control group (1,310.6\u00a0\u00b1\u00a0250.0\u00a0\u03bcm). Correlation analysis in the VBD and GSM groups between low vestibular mucosa thickness and symptom intensity (burning\/pain and dyspareunia) showed a significant correlation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with VBD have a vestibular mucosa with a lower thickness than healthy women of the same age, with an almost identical value to that found in postmenopausal women. Furthermore, a low vestibular mucosa thickness in the VBD and GSM groups showed a significant correlation with burning\/pain intensity and dyspareunia severity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.esxm.2020.100320","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T18:31:26Z","timestamp":1613413886000},"page":"100320-100320","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Vestibular Mucosa Thickness Measured by Ultrasound in Patients Affected by Vestibulodynia: A Case-Control Study"],"prefix":"10.1093","volume":"9","author":[{"given":"Filippo","family":"Murina","sequence":"first","affiliation":[{"name":"Lower Genital Tract Disease Unit, V. Buzzi Hospital\u2013University of the Study of Milan , Milan , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Lower Genital Tract Disease Unit, V. Buzzi Hospital\u2013University of the Study of Milan , Milan , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Lubrano","sequence":"additional","affiliation":[{"name":"Lower Genital Tract Disease Unit, V. Buzzi Hospital\u2013University of the Study of Milan , Milan , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Cetin","sequence":"additional","affiliation":[{"name":"Lower Genital Tract Disease Unit, V. Buzzi Hospital\u2013University of the Study of Milan , Milan , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"2023012008402375800_bib1","first-page":"607","article-title":"ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia","volume":"13","author":"Bornstein","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023012008402375800_bib2","first-page":"82","article-title":"A\u00a0population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?","volume":"58","author":"Harlow","year":"2003","journal-title":"J\u00a0Am Med Womens Assoc"},{"key":"2023012008402375800_bib3","doi-asserted-by":"crossref","first-page":"170-e1","DOI":"10.1016\/j.ajog.2011.08.012","article-title":"Prevalence and demographic characteristics of vulvodynia in a population-based sample","volume":"206","author":"Reed","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"2023012008402375800_bib4","first-page":"291","article-title":"Vulvodynia: Definition, prevalence, impact, and pathophysiological factors","volume":"13","author":"Pukall","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023012008402375800_bib5","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1016\/j.pain.2014.05.010","article-title":"Vulvodynia: Current state of the biological science","volume":"155","author":"Wesselmann","year":"2014","journal-title":"Pain"},{"key":"2023012008402375800_bib6","first-page":"592","article-title":"Heightened pelvic floor muscle tone and altered contractility in women with provoked vestibulodynia","volume":"14","author":"Morin","year":"2017","journal-title":"J\u00a0Sex Med"},{"key":"2023012008402375800_bib7","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ijgo.2014.05.020","article-title":"Prevalence of vulvodynia and risk factors for the condition in Portugal","volume":"127","author":"Vieira-Baptista","year":"2014","journal-title":"Int J Gynaecol Obstet"},{"key":"2023012008402375800_bib8","first-page":"1679","article-title":"Vulvar vestibulitis syndrome and estrogen dose of oral contraceptive pills","volume":"4","author":"Greenstein","year":"2007","journal-title":"J\u00a0Sex Med"},{"key":"2023012008402375800_bib9","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1111\/1471-0528.12407","article-title":"Oral contraceptive use and risk of vulvodynia: a population-based longitudinal study","volume":"120","author":"Reed","year":"2013","journal-title":"BJOG"},{"key":"2023012008402375800_bib10","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1097\/GME.0000000000000329","article-title":"Vulvovaginal atrophy terminology consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the study of Women\u2019s sexual health and the North American menopause Society","volume":"21","author":"Portman","year":"2014","journal-title":"Menopause"},{"key":"2023012008402375800_bib11","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.ejogrb.2016.10.016","article-title":"Coital pain in the elderly: could a low dose estriol gel thrill the vulvar vestibule?","volume":"207","author":"Murina","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2023012008402375800_bib12","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1111\/srt.12884","article-title":"High-frequency ultrasound skin thickness: Comparison of manual reading and automatic border detection includes assessment of interobserver variation of measurement","volume":"26","author":"Alsing","year":"2020","journal-title":"Skin Res Technol"},{"key":"2023012008402375800_bib13","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000210760","article-title":"Measurement of epidermal thickness in normal skin and psoriasis with high-frequency ultrasound","volume":"1","author":"Hermann","year":"1988","journal-title":"Skin Pharmacol Physiol"},{"key":"2023012008402375800_bib14","doi-asserted-by":"crossref","first-page":"311.e1","DOI":"10.1016\/j.ajog.2007.09.041","article-title":"Steroid receptor expression and morphology in provoked vestibulodynia","volume":"198","author":"Johannesson","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"2023012008402375800_bib15","doi-asserted-by":"crossref","first-page":"745","DOI":"10.14740\/jocmr4006","article-title":"Histological and gene expression analysis of the effects of menopause status and hormone therapy on the vaginal Introitus and Labia Majora","volume":"11","author":"Binder","year":"2019","journal-title":"J\u00a0Clin Med Res"},{"key":"2023012008402375800_bib16","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1089\/biores.2019.0049","article-title":"Expression of estrogen-related receptors in localized provoked vulvodynia","volume":"9","author":"Aalto","year":"2020","journal-title":"Biores Open Access"},{"key":"2023012008402375800_bib17","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1067\/S0002-9378(03)00365-X","article-title":"Estrogen receptor expression in vulvar vestibulitis syndrome","volume":"189","author":"Eva","year":"2003","journal-title":"Am J Obstet Gynecol"},{"key":"2023012008402375800_bib18","first-page":"2764","article-title":"Polymorphisms of the androgen receptor gene and hormonal contraceptive induced provoked vestibulodynia","volume":"11","author":"Goldstein","year":"2014","journal-title":"J\u00a0Sex Med"},{"key":"2023012008402375800_bib19","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/j.1365-2133.2007.08066.x","article-title":"The vulval vestibular mucosa-morphological effects of oral contraceptives and menstrual cycle","volume":"157","author":"Johannesson","year":"2007","journal-title":"Br J Dermatol"},{"key":"2023012008402375800_bib20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/j.pain.0000000000000094","article-title":"What is special about the vulvar vestibule?","volume":"156","author":"Farmer","year":"2015","journal-title":"Pain"},{"key":"2023012008402375800_bib21","first-page":"657","article-title":"Skin thickness measurement by pulsed ultrasound; its reproducibility, validation and variability","volume":"106","author":"Tan","year":"1982","journal-title":"Br J Dermatol"},{"key":"2023012008402375800_bib22","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1365-2230.1984.tb00797.x","article-title":"The determination of skin thickness using conventional diagnostic ultrasound equipment","volume":"9","author":"Kirsch","year":"1984","journal-title":"Exp Dermatol"}],"container-title":["Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2050116120302087?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2050116120302087?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/smoa\/article-pdf\/9\/2\/100320\/48796643\/smoa_9_2_100320.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/smoa\/article-pdf\/9\/2\/100320\/48796643\/smoa_9_2_100320.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T09:12:33Z","timestamp":1674205953000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/smoa\/article\/9\/2\/100320\/6956578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,12]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.esxm.2020.100320","relation":{},"ISSN":["2050-1161"],"issn-type":[{"value":"2050-1161","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4]]},"published":{"date-parts":[[2021,2,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Vestibular Mucosa Thickness Measured by Ultrasound in Patients Affected by Vestibulodynia: A Case-Control Study","name":"articletitle","label":"Article Title"},{"value":"Sexual Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.esxm.2020.100320","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.","name":"copyright","label":"Copyright"}]}}