Abstract
She has been working as a teacher, loves her profession. She has been married for 30 years. Menopause since the age of 49. One childbirth. Sexual debut: at the age of 19, one sexual partner. During gynecological examination the diagnosis was as follows: atrophic colpitis, reduction of estrogen and androgen levels in blood. We have carried out ultrasonography of clitoris zone in the state of peace and at the background of video- and arousing lubricants in the diagnostic system XARIO of TOSHIBA expert level in the mode of grey scale (B-mode) with the use of colored Doppler carding and determining speed indices. Multifrequency linear sensor 7.0- 12.0 MHz has been used. With the colored Doppler carding we assessed the peculiarities of parenchymatous blood flow in clitoris (presence, absence, intensiveness and symmetry). We used the scanning angle between ray and vessel from 0 to 40 degrees. Indicators of 3-4 complexes were assessed. Doppler indices: peak systolic speed of blood flow (Vps m/s), index of resistance (IR), index of pulsation (IP), and volume speed of blood flow (Vvol ml/min). The size of glans of clitoris: right one – 0.6 cm, left one – 0.7 cm (in sexually healthy women 1.1 ± 0.05 cm), volume (V cm3) of bodies amounted to 0.7 cm3 and 0.8cm3 (N 1.32 ± 0.5 cm3). Diameter of cavernous arteries in peace 0.45 and 0.5 cm (in sexually healthy women 0.7 ± 0.5 cm – 0.9 ± 0.5 cm). Doppler metric indices before stimulation: IR (index of resistance) 0.82-0.87 (N 0.6-0.62 ± 0.05), IP (index of pulsation) 2.8-2.4 (N 1.2 ± 0.05), Vs (maximum systolic speed) was 3.4-4.4 cm/s (N 6.0 – 8.0 ± 0.5 cm/s), and Vsp (voluminous blood flow) respectively 1.6 – 1.7 ml/s (N 2.0-4.0 ± 0.05 ml/s). At the background of arousal blood flow indices did not change: IR (index of resistance) 0.8-0.77; IP (index of pulsation) 2.5-2.7, Vps (maximum systolic speed) 5.3-7.2 ± 0,5 cm/s, Vps (voluminous blood flow) 2.0-2.5 ± 0,05 ml/s; certifying the presence of dyspareunia.
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