Kastelein AW, Diedrich CM, Jansen CHJR, et al. - Researchers examined the correlation of noninvasive focal depth (FD) measurements with the vaginal wall epithelial thickness (ET). If ET of the vaginal wall could be accurately determined using FD, noninvasive longitudinal assessment of (newly developed) treatment modalities aiming to increase ET would be possible, without the requirement for invasive biopsies. Among 14 women, median age 62 years (inter quartile ranges: 57-65), undergoing vaginal prolapse surgery because of anterior and/or posterior compartment pelvic organ prolapse, FD measurements of the vaginal wall before surgery were done using the CytoCam, a handheld video microscope based on incident dark-field imaging and ET was measured in stained sections of tissue that was removed during the surgical procedure. Comparison of 17 ET measurements (mean 125 μm ± 38.7, range 48-181 μm) with 17 FD measurements (mean 128 μm ± 34.3, range 68-182 μm) was done. Good agreement between ET and FD measurements was observed. The mean difference described with Bland-Altman analysis was regarded as acceptable for these measurements. This suggests the accuracy of FD in reflecting ET, which supports the employment of FD to estimate ET of the vaginal wall. For a complete assessment of the vaginal wall, they suggest combining FD measurements with the assessment of vaginal angioarchitecture.