UC Irvine

Genitourinary syndrome of menopause (GSM) is a condition that affects more than half of postmenopausal women, significantly impairing their quality of life. Characterized by symptoms such as vaginal dryness, burning, itching, irritation, and increased urinary frequency and urgency, GSM presents a substantial challenge in both diagnosis and treatment due to its varied manifestations and the non-life-threatening nature of the condition. Traditional approaches to diagnosis and treatment, reliant on subjective assessments such as tactile examinations by physicians or self-scoring by patients, are limited in their effectiveness and hinder the standardization of care protocols.This dissertation develops a novel endoscopic system integrating Optical Coherence Tomography (OCT), OCT Angiography (OCTA), and Optical Coherence Elastography (OCE) to provide a comprehensive, high-resolution view of vaginal tissue structure, vasculature, and mechanical properties. The developed system aims to overcome the limitations of current diagnostic methods by offering objective, quantifiable data that assists in the accurate assessment and monitoring of GSM. The dissertation describes the design and development of the OCT/OCTA/OCE system, detailing the technical specifications and functionalities that enable detailed visualization and measurement of vaginal epithelial thickness and blood vessel density. Validation of the system was performed through imaging studies involving 83 women across different menopausal statuses, demonstrating the system's ability to consistently deliver high-quality assessments of vaginal tissue integrity. Further applications of the system were explored in a clinical study with 25 GSM patients undergoing fractional-pixel CO2 laser treatment. The system's capabilities were extended to monitor changes in vaginal tissue post-treatment, providing vital insights into treatment efficacy and tissue response. Additionally, the integration of a piezoelectric transducer (PZT)-based shear wave OCE approach facilitated ex vivo imaging of sheep vaginal tissue, showcasing the system's potential in preclinical settings. Overall, the OCT/OCTA/OCE endoscopic system represents a significant advancement in the management of GSM. By enabling precise screening patients, monitoring GSM progression, and evaluating individual responses to treatment, this system equips clinicians and researchers with a critical tool to tailor and optimize therapeutic strategies for GSM. The implications of this research extend beyond immediate clinical applications, suggesting a pathway towards more personalized and effective treatment paradigms for various gynecological conditions.