Distribution of topical medication in the human vagina as imaged by magnetic resonance imaging

Kurt Barnhart, E. Scott Pretorius, Alan Stolpen, Daniel Malamud

Research output: Contribution to journalArticle

Abstract

Objective: To assess the use of magnetic resonance imaging (MRI) to determine the varying distribution of a vaginally placed gel over time and with different levels of patient activity. Design: Prospectives interventional trial. Setting: University medical center. Patient(s): One nulliparous volunteer with normal menstrual cycles and no gynecologic disease who underwent seven MRI scans of the pelvis. Intervention(s): Five mL of a commercially available topical spermicide was mixed with gadolinium-chelate magnetic resonance contrast material and introduced with a standard applicator. T1-weighted three-dimensional MRI was done to assess the distribution of the gel. Main Outcome Measure(s): Gel thickness and distribution. Result(s): The initial bolus of gel was delivered into the upper portion of the vagina, above the urogenital diaphragm. Thereafter, it spread into the vaginal fornices and 'flattened' to cover the lateral aspects of the vagina. Without ambulation, the majority of spread was confined to the upper vagina. With ambulation and longer elapsed time, the gel spread further in the upper vagina and into the lower vagina, and significant vaginal surface coverage increased significantly. Conclusion(s): Magnetic resonance imaging can be used to monitor the spread of vaginally placed products and to evaluate coverage of topical drugs used for prevention and treatment, including those used for HIV prophylaxis.

Original languageEnglish (US)
Pages (from-to)189-195
Number of pages7
JournalFertility and Sterility
Volume76
Issue number1
DOIs
StatePublished - 2001

Fingerprint

Vagina
Gels
Magnetic Resonance Imaging
Walking
Female Genital Diseases
Gadolinium
Menstrual Cycle
Diaphragm
Pelvis
Contrast Media
Healthy Volunteers
Magnetic Resonance Spectroscopy
Outcome Assessment (Health Care)
HIV
Pharmaceutical Preparations

Keywords

  • Formulation
  • HIV
  • Magnetic resonance imaging
  • Microbicide
  • Nonoxynol-9
  • Product distribution
  • Three-dimensional imaging
  • Vagina

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Distribution of topical medication in the human vagina as imaged by magnetic resonance imaging. / Barnhart, Kurt; Pretorius, E. Scott; Stolpen, Alan; Malamud, Daniel.

In: Fertility and Sterility, Vol. 76, No. 1, 2001, p. 189-195.

Research output: Contribution to journalArticle

Barnhart, Kurt ; Pretorius, E. Scott ; Stolpen, Alan ; Malamud, Daniel. / Distribution of topical medication in the human vagina as imaged by magnetic resonance imaging. In: Fertility and Sterility. 2001 ; Vol. 76, No. 1. pp. 189-195.
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