Structural and Functional Bases of Genitourinary Syndrome of Menopause

Abstract

We performed a comprehensive clinical and morphological examination of 70 menopausal patients aged 42-62 years with dysuria and chronic pelvic pain. Assessment of the bladder and vaginal microcirculation by laser Doppler flowmetry in menopausal patients with genitourinary syndrome revealed reduced (by 12-65%) microcirculation parameters. Analysis of the quantitative and qualitative composition of the bacterial microflora of the urethra and vagina revealed abnormalities of microbiota of varying severity, which can be the cause of infectiousinflammatory processes in the pelvic organs leading to chronic pelvic pain syndrome and incontinence. During menopause, the genitourinary syndrome in women is associated with the combined development of atrophic changes in the bladder and uterine mucosa that by their morphological characteristics differ from age-related involutive changes. Atrophy (hypoplasia) of the endometrium and bladder mucosa develops against the background of pronounced fibrosis and is accompanied by hyperemia and hemorrhages.