Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work is presented thanks to the support of: SEGERF

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): CLINICAL STAFF

Were you provided with any honoraria, payment or other compensation for your work on this study?
Yes
Please specify entities (individual, company, society): BTL AESTHETICS ESPANA

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work is presented thanks to the support of: BTL AESTHETICS ESPANA

Objectives: Our goal is to show that microfat, nanofat grafting can be effective in this indication. This study aims to present our technique, analyzing effectiveness, patient satisfaction, duration, and complications.

Introduction: Genital restoration is growing in recent years. It can improve vaginal dryness, mucosa trophicity, genito-urinary symptoms of menopause (GSM) and loss of elasticity and volume of external genitalia.

Materials / method: Patients presenting vaginal trophic disorders, atrophy of labia majora, and GSM were included.
After abdominal fat harvesting (or internal face of the knees, or thighs) and fat graft preparation, a microfat and nanofat grafting was performed in the genital area.
8 ml of microfat was injected in the labia majora and 6 ml of nanofat in the vestibule, the G spot area, and the first 3 centimeters of the vagina wall (posterior and lateral)
Fridmann score and Female Sexual Distress Scale (FSD) were used to evaluate the results, the effectiveness and tolerance of the treatment.

Results: 100 patients benefited from this technique. A significative improvement of the Fridmann score, pH, and FSD scale was found for all patients, with particular benefit on dryness, pH and dyspareunia.
No complication was found in our study. The follow up is 36 months, all results are stable

Conclusion: This study demonstrate that functional disorders of intimate sphere can be treated by micofat, nanofat grafting.
This autologous procedure is able to provide a very good rejuvenation of genital area.
This method was effective in all patients, required a single session for at least 36 months.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: To find a cytological parameter that allows us to proactively indicate a non-ablative laser treatment to improve vaginal trophism, and to correlate it with post-treatment histological changes in women with severe asymptomatic vaginal atrophy, to avoid future unpleasant symptomatic episodes for the patient.

Introduction: Seeking a reduction of the the risk of suffering the possibility of future symptoms of the so-called Genitourinary Syndrome of Menopause.

Materials / method: 40 postmenopausal patients with severe, asymptomatic vaginal atrophy were enrolled in this study. Previous cytological evaluation confirming a maturation index of the epithelium less than 25 done, atrophy compatible, in all. Biopsies performed on smaller group, then single session of non-ablative Erbium:YAG laser, determining if rate of maturation value could improve, to remove vulnerability of suffering symptoms and correlate changes with histological findings. 33 were followed-up for a year, with cytological evaluation (maturation value index) and biopsies in some at 1, 3, 6 and 12 months.

Results: A significant improvement in the epithelial maturation value index was observed in one hundred percent of the treated patients, going from less than 25 to more than 50, and in many of them even more than 65, which means proper trophism. These changes were also correlated with the histological improvement expressed in increment of the epithelial thickness, the glycogenic load and the amount of vascularization in the lamina propria. These outcomes were maintained during the twelve months of follow-up.

Conclusion: The results show that carrying out a single session of non-ablative Erbium:YAG laser to asymptomatic postmenopausal patients reduces the risk of suffering the possibility of future symptoms of the so-called Genitourinary Syndrome of Menopause.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
Yes
Please specify date...: vaginal treatments
and status : erbium laser

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: - Indications of hyaluronic acid injection in vulva and vagina.
- Injection technique of HA in vulva and vagina.
- Post-treatment care.
- Management of complications.

Introduction: Vulvo-vaginal atrophy (VVA) is part of the Menopause Genitourinary Syndrom of Menopause (GSM) and is a common pathology in women, with prevalences between 10% and 50%. Common symptoms include vaginal dryness, irritation, itching and dyspareunia. Estrogen deficiency is responsible for most of the anatomical, cytological, bacteriological and physiological changes that occur in the female reproductive system after menopause. VVA can be the cause of vulvovaginal dysfunction that affects sexuality and other aspects that alter the quality of life of women causing a negative emotional impact on them

Materials / method: The HA that is injected into the vagina must be of low cross-linking, and the HA that is injected into the labia majora must be of high cross-linking. HA can be injected into the posterior wall of the vagina, the vestibule and labia majora. It should not be injected into the clitoris or anterior vaginal wall to avoid complications. In the vaginal mucosa the injection technique is by multi-puncture as a mesotherapy. In the labia majora it is injected with cannula retrogradely. It is recommended to repeat the HA injection every year and it can be combined with laser and radiofrequency.

Results: The effects of hydration HA on the vaginal mucosa and the vestibule are an increase in lubrication and trophicity, a reduction in dyspareunia, intimate discomfort, itching and pH alterations. The effects of the volumizing HA on the labia majora are to return its turgidity, improve the protection of the vaginal introitus and thus preserve the natural moisture of the vagina, improve itching, and achieve an aesthetic rejuvenation of the female genitalia.

Conclusion: HA injection is an effective and safe treatment of VVA in patients with GSM.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No
Please specify entities (individual, company, society): He sido formadora de Isdin España en técnica de inyección de Desirial.

Were you provided with any honoraria, payment or other compensation for your work on this study?
Yes
Please specify entities (individual, company, society): He sido formadora en el pasado de Isdin España en técnicas de inyección de Desirial.

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: Our objective is clinical evaluation of the vulvovaginal dryness treatment by a new non-crosslinked HA device, containing oligopeptides and antioxidants.

Introduction: Vaginal dryness is the most reported complaint by patients affected by the “Genitourinary Syndrome of Menopause – GSM”. This syndrome affects, in Western Countries, approximately the 80% of women in peri- or post-menopause; however, it results underdiagnosed and undertreated, despite the wide possibility of therapy. Between the available treatments, in the last few years the use of Hyaluronic Acid (HA) injected in vagina and labia majora to improve vaginal dryness and labia majora atrophy, is increased. This treatment, at first, was considered as a vaginal rejuvenation. Recently, a new non-crosslinked HA device, containing oligopeptides and antioxidants, has been put on the market. We decided to evaluate his clinical efficacy and reliability.

Materials / method: We enrolled 10 women, aged 45 to 62 years, all affected by GSM. The diagnosis of GSM was made by collecting personal history, clinical examination, and basing on Vaginal Health Index (VHI). Photographs were taken of each patient before and after the treatment, in a single projection showing the shape of external genitalia. A questionnaire was also submitted to each patient, before and after the treatment, to evaluate the perception of the symptoms constituting the GSM. Each patient was treated once a week, for 6 weeks, with 1 ml of a new non-crosslinked HA device, containing oligopeptides and antioxidants, following a honeycomb design on the entire area to be treated. To reduce the discomfort, before each session a local anesthetic cream was applied to the area.

Results: All patients completed the treatment cycle. All patients reported an improvement in symptoms, particularly vaginal dryness. Photographs show a restoration of the volume of the labia majora and the improvement in their function to protect the vaginal vestibule.

Conclusion: This non-crosslinked HA device, containing oligopeptides and antioxidants, for the formulation and the simplicity of the technique of use, appears as a very promising device for the treatment of symptoms of GSM, particularly of the vaginal dryness. However, the quality and duration of the results obtained must be verified with further clinical studies.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability