Vaginal distribution of Replens® and K-Y® Jelly using three imaging techniques

• Published in: Contraception (Stoneham) Vol. 77; no. 3; pp. 195 - 204
• Main Authors: Mauck, Christine K, Katz, David, Sandefer, Erik P, Nasution, Marlina D, Henderson, Marcus, Digenis, George A, Su, Irene, Page, Richard, Barnhart, Kurt
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2008; Elsevier Science
• Subjects: Administration, Intravaginal; Adult; Biological and medical sciences; Birth control; Body Mass Index; Cellulose - administration & dosage; Cellulose - analogs & derivatives; Cellulose - pharmacokinetics; Colposcopy - methods; Cross-Over Studies; Distribution; Emollients - administration & dosage; Emollients - pharmacokinetics; Female; Fiber Optic Technology; Fiberoptic; Genital system. Reproduction; Glycerol - administration & dosage; Glycerol - pharmacokinetics; Gynecology. Andrology. Obstetrics; Humans; Imaging; Lipids - administration & dosage; Lipids - pharmacokinetics; Magnetic Resonance Imaging; Medical sciences; Microbicide; MRI; Obstetrics and Gynecology; Other methods of contraception. Sterilization; Parity; Pharmacology. Drug treatments; Phosphates - administration & dosage; Phosphates - pharmacokinetics; Pregnancy; Propylene Glycols - administration & dosage; Propylene Glycols - pharmacokinetics; Radionuclide Imaging; Scintigraphy; Spreading; Time Factors; Tissue Distribution; Vagina; Vagina - diagnostic imaging; Vagina - metabolism; Vaginal Creams, Foams, and Jellies - pharmacokinetics; Walking; MRI; Spreading; Imaging; Distribution; Microbicide; Vagina; Fiberoptic; Scintigraphy; Intravaginal administration; Nuclear magnetic resonance imaging; Antimicrobial agent; Displacement; Colloidal gel; Body mass index; Dosage form; Medical imagery; Commercial form; Pharmacokinetics; Parity; Comparative study
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2007.11.016

Abstract Background Determination of vaginal distribution is important to the development of potential vaginal microbicidal or spermicidal products. Study Design This was a descriptive study of three imaging techniques with a randomized crossover assignment of two gels and activity status within each technique. Method Each of three sites utilized one technique. Three nulligravid women and three parous women were to be enrolled at each site. We studied the effects of time, ambulation, parity and body mass index on vaginal spreading of two commonly used gels, K-Y® Jelly and Replens®. Imaging by magnetic resonance imaging and gamma scintigraphy was performed at 5, 20, 35 and 50 min after insertion of 3.5 mL of gel. Imaging with a fiberoptic probe was performed at 5 and 20 min after insertion. Results Initial application of the gel resulted in approximately two thirds of maximum coverage possible, both in linear extent along the vaginal axis and in surface area covered. Over the next 45 min, spreading increased to about three quarters of the maximum possible. Ambulation generally increased linear spreading and the proportions of women with gel at the introitus and os. Effects of parity and body mass index (BMI) were similar on most measures of gel spreading, with nulligravid women tending toward greater spread than parous women and women of high BMI usually showing somewhat greater spread than women of normal weight. Differences between the two gels were not seen when all conditions of application were considered together. Conclusion In vivo imaging of gel distribution demonstrated that ambulation, parity and BMI affect vaginal gel spreading. The three imaging techniques have advantages and disadvantages and provide complementary information for microbicide development.