Ultrasound measurement of vaginal wall thickness: a novel and reliable technique

The aim of this study was to validate a technique to measure the vaginal wall thickness (VWT) using two-dimensional ultrasound. Women were scanned by two independent operators and by the same operator at two separate visits at the level of the bladder neck, the apex of the bladder, the anterior fornix, the anorectal junction, rectum and posterior fornix. Fresh female cadavers were scanned and ultrasound thickness of the vagina was compared to histological thickness. Bland Altman analysis revealed a low mean difference between operators and between visits by the same operator. The 95% confidence intervals as a percentage of the mean vaginal wall thickness ranged between 2.8% and 7.4%. There was a low percentage difference between ultrasound and histological vaginal wall thickness. Ultrasound vaginal wall thickness demonstrated good intra- and interoperator reliability, as well as consistency with histological measurement. It is a valid technique.