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IMCAS World Congress 2022
Program

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FOCUS ON S086

Contributing lectures - Genital treatments

Room: Room 153 - Level 1
Date: Saturday 4 June 2022 at 08:30 to 10:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Adrian GASPAR

Gynecologist

Argentina

Dr Elena RUMYANTSEVA MATHEY

Dermatologist

France

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
08:30		Introduction		112429
08:32	Dr Lubomir MIKULASEK	Pelvic floor dysfunction in female patients treated by HIFEM technology: safety and efficacy study	View	114300
08:40	Dr Giovanna IGNACIO	Novel technique of vulvar rejuvenation with HIFU in post-bariatric patient: a case report	View	114320
08:48	Dr Vladlena Igorevna AVERINA	Injectable complications in aesthetic gynecology	View	114322
08:56	Dr Nadia YOUSRI	Labia majora augmentation with HA dermal filler	View	114319
09:04	Dr Diala HAYKAL	Pilot descriptive study of the evolution of genitourinary symptoms with gynecological laser treatment	View	114317
09:12	Dr Michael L KRYCHMAN	Research and development of a vulvar moisturizer to target unmet gynecological and aesthetic needs	View	115028
09:20	Dr Bulent CIHANTIMUR	Genital harmonization: a clinical experience with a combined approach	View	116663
09:28	Dr Tinatin TOMADZE	Modern methods in functional and aesthetic gynecology	View	115027
09:36	Dr Jamila ATANNAZ	Wedge labia minora reduction: tips and tricks for better outcome and less complications	View	116835
09:44		Q&A		114324

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Recommended sessions

Vaginal rejuvenation (non-surgical)

Atrophic vaginitis

Energy-based devices (EBD)

Stress urinary incontinence (SUI)

Fillers: HA (hyaluronic acid)

Introduction

Dr Lubomir MIKULASEK

Gynecologist

Czech Republic

Other author(s) : Lubomir Mikulasek

Pelvic floor dysfunction in female patients treated by HIFEM technology: safety and efficacy study

Objectives: The outbreak of new technologies opens new possibilities for treatment of pelvic floor dysfunctions. Such technology is HIFEM (High-Intensity Focused Electromagnetic Technology) which uses magnetic fields to stimulate muscles of pelvic floor which significantly contributes to intimate health. Goal of this study is to investigate the safety and efficacy of this technology.

Introduction: Incontinence and other pelvic dysfunction is a rapidly expanding field. At the time patients can choose either Kegels, Drugs, Nerve stimulation, EBD‘s, surgery, pads, Vaginal pessary or psychotherapy. But many options are not ideal. Patients desire non-invasive procedures. Treatment, to be successful, need to address: Skin, Connective tissues and Muscles, and all this is fulfilled by hifem technology.

Materials / method: A total of 21 females (average age 53.8±15.2) suffering from pelvic issues such as urine incontinence, pelvic organ prolapse, introital laxity, vaginal relaxation syndrome or sexual dysfunction were recruited. The subjects received a treatment procedure with device utilizing HIFEM technology. The procedure consisted of 6 sessions, spaced by 3-4 days and each lasting for 28 minutes. The effects of the procedure were evaluated using ultrasound imaging along with the ICIQ-F questionnaire. The final ICIQ score was calculated as a sum of question 3,4 and 5. Furthermore, treatment comfort was monito

Results: Analysis of the ICIQ questionnaire shows that the score decreased from 6.2±4.9 at baseline to 3.1±3.9 after 6th session. After the treatments a total of 10 patients had score of 0. The patient with the most severe condition improved from 16 at baseline to 13 post treatments. Ultrasound images show significant improvement in pelvic floor strength. The results were accompanied with high patient satisfaction and in 16/21 patients the outcomes exceeded expectations. The treatments were perceived as comfortable. The treatments are showed a very fast onset of a significant positive effect as patient

Conclusion: The non-invasive HIFEM technology for the treatment of wide group of pelvic muscles and functional disorders together with psychological aspects is an easy to use and safe procedure with excellent results. It is well suited in-office procedure with positive outcomes and is an acceptable treatment option, which should be considered as a first choice prior to use of invasive techniques.

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

Dr Giovanna IGNACIO

Gynecologist

Brazil

Other author(s) : Badra de Oliveira Capita

Novel technique of vulvar rejuvenation with HIFU in post-bariatric patient: a case report

Objectives: Introduce a non-surgical technique of vulvar rejuvenation using High Intensity Focused Ultrassound (HIFU) in two female post-bariatric patients.

Introduction: The use of High Intensity Focused Ultrassound (HIFU) in cosmetogynecology is a new therapy for the treatment of vulvar tissue flacity. As we know, female genital cosmetic surgeries (FGCS) have been performed for a long time to treat this condition, but, know days patients look for aesthetic treatments that do not require down time. Post-bariatric patients are conditioned to undergo reconstructive plastic surgery, such as abdominoplasty and mammoplasty, after major weight loss. But, there was always something to be repaired in the genital region, which also becomes flaccid after weight loss.

Materials / method: In January 2020, two female post-baritric patients, both 42 years-old and average loss of 60 pounds, showing an advanced degree of flaccidity of the vulva, had this complaint treated with 2 sessions of HIFU, replacing the conventional labia majora's surgery. The HIFU Vulvar Rejuvenation Protocol was developed by the author and now days have more than 30 patients effectively treated with excellent aesthetic results.

Results: In both cases, the vulvar tissue flaccidity had an improvement of more than 70%, thus dispensing the traditionally labia majora lifting performed surgery. The patients were absolutely satisfied for having an effective result on the flacity treatment, with a non-invasive procedure without down time and without scars.

Conclusion: Vulvar rejuvenation treatment with HIFU seems promising to improve tissue tightening, completely dispensing with the need for FGCS surgery. This innovative protocol offers satisfactory improvement in vulvar flaccidity, a comfortable procedure for the patient, absence of down time and a sustained effect result for at least 2 years.

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

Dr Vladlena Igorevna AVERINA

Dermatologist

Ukraine

Other author(s) :

Injectable complications in aesthetic gynecology

Objectives: To avoid complications in Aesthetic Gynecology, to know their management

Introduction: Injections for aesthetic and functional corrections in Aesthetic Gynecology are very common. This field of aesthetic medicine is growing. Some methods and techniques of treatment potentially provide women with functional beauty and health.
But sometimes injectable corrections can lead to serious problems

Materials / method: Complications can be divided by functional, sensitive and aesthetic. Also by etiology: anatomical, technical and immunological

Conclusion: Knowledges about possible complications and their management give doctors secured and successful work, and increase quality of life of their patients

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

Dr Nadia YOUSRI

Gynecologist

United Kingdom

Other author(s) : none else

Labia majora augmentation with HA dermal filler

Objectives: highlighting that Labial augmentation procedure using Hyaluronic Acid as non-surgical option that could successfully reverse the hypotrophy changes & dysfunctions happening in Female External Genitalia.

Introduction: There are Gynaecological symptoms resulting from the anatomical & physiological changes in the Female External Genitalia happening during Childbirth, Menopause or simply a part of Aging process etc all undermine the quality of the tissues and the gross Aesthetic anatomical appearance. The traditional options were either limited or drastic (surgery). The non-surgical procedures are increasingly gaining popularity everyday with increasingly practice- evidenced high success rate not only in treating such crippling symptoms but also in reversing the distorted/ non-Aesthetic appearance too.

Materials / method: literature review on treatable Gynaecological symptoms, clinical anatomy, potential use of HA, merits, technique’s safety tips & presenting own experience & own case studies’ series

Results: presenting slides of before & after of various cases treated by the author herself

Conclusion: HA Dermal Filler, has merits that are proved very beneficial to reverse the dysfunctions & the un-Aesthetic changes that happen in Labia Majora area.

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

Dr Diala HAYKAL

France

Other author(s) :

Pilot descriptive study of the evolution of genitourinary symptoms with gynecological laser treatment

Objectives: The objective of this study is to evaluate the effectiveness of the fractional ablative CO2 laser in the treatment of genitourinary symptoms. Treatment with gynecological CO2 laser provides benefits in terms of improving symptoms of genitourinary discomfort, as well as the quality of life of our patients. The is indeed an aesthetic medicine of the Intimate "The vulvovaginal restoration".

Introduction: Vaginal discomfort, related to genitourinary syndrome affects a large number of women, and is responsible for a significant deterioration in their quality of life. As such, its management represents a public health issue. Systemic or local treatments proposed, have a moderate and transient efficacy, with undesirable effects and contraindications caused by hormonal treatments. The CO2 laser is now part of the therapeutic arsenal, it is an effective alternative , without adverse effects, with growing interest.

Materials / method: I conducted a pilot, descriptive study, from January 2 to April 30, 2020, using a questionnaire, specific to the criteria of gynecological and urinary discomfort based on the FSFI (Female Sexual Function Index), the SFU grid and the impact of these symptoms on the quality of life of the patient. This questionnaire was distributed and completed by the patient, at each treatment session. The total number of patients included was 15, ranging in different age groups. The treatment time was 10 to 15 min. Three sessions were performed, spaced one month apart.

Results: All the patients were improved at the end of the 3rd laser session, regardless of the patient's initial indication, with a decrease or even disappearance of the symptoms of gynecological discomfort, as well as an improvement in the signs of mild to moderate urinary incontinence, and an improvement in the quality of life of all the patients. All the patients had a follow up one year later but none have called back since the end of their treatment to report failure, unwanted side effects, or premature return of symptoms. Clinical Randomized therapeutic trials are still needed.<<<<<

Conclusion: In daily practice, the patient does not talk spontaneously about their sexual problems, these disorders affect many couples and the subject is still taboo!
CO2 laser treatment is efficient. It provides benefits in terms of improving symptoms of genitourinary discomfort, as well as the quality of life of our patients. There is indeed an intimate aesthetic medicine and a vulvovaginal restoration, this treatment arouses a growing interest.
Good sexual Development is the key to Anti-Aging.

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

Dr Michael L KRYCHMAN

Gynecologist

United States

Other author(s) : Michael Krychman MD, MPH, Alisar S. Zahr, PhD; Tatiana Kononov, BS, MBA

Research and development of a vulvar moisturizer to target unmet gynecological and aesthetic needs

Objectives: A novel vulvar moisturizer product (VMP) was formulated and tested in a prospective study that was conducted to assess consumer acceptance and tolerability of the VMP when used by healthy women twice-daily for the duration of four weeks.

Introduction: There is a limited number of peer-reviewed publications concerning non-invasive topically genital cosmetic products. The vulvar area has received limited research in the cosmetic and skincare industry. Topical creams exist primarily as medical interventions; however, topical cosmetic products are an unmet consumer need in that they have less risk than surgical intervention when seeking enhancement or improvement of the female genital appearance. The unmet consumer need can be realized with a non-invasive vulvar moisturizer developed to improve vulvar aesthetics.

Materials / method: The VMP formulation delivery system includes a reverse emulsion containing emollients, antioxidants, skin protectants and moisturizing ingredients with technology to allow for prolonged skin soothing and moisturization. An IRB-approved single-center consumer in-use study that was performed at a USA based center. 25 female subjects, 18-85 years old, in good gynecological health were recruited for this study. Subjects applied the VMP on the external vulvar tissue twice daily for 4 weeks. Subjective tolerability measurements and self-assessment were completed. A binomial exact test was preformed.

Results: The VMP completed 12-weeks of accelerated stability and packaging shelf-life criteria. 25 female subjects completed the consumer in-use study. Subjects were primarily Caucasian (48%) and 44% Hispanic. Self-assessment results indicated highly statistically (***p < 0.001) favorable responses for each category: vulva perception, product characteristics, product package, and overall satisfaction. Subjects felt that the VMP was formulated with high-quality non hormonal ingredients. Subjective tolerability evaluation showed the VMP yielded no burning, itchiness, stinging or other adverse reactions.

Conclusion: This single-center consumer in-use study supports the hypothesis that the VMP when used twice daily for four weeks achieved consumer acceptance and was tolerable. Consumer acceptance was demonstrated in all self-assessment categories, vulva perception, product characteristics, packaging, and overall satisfaction. Further research is currently being conducted with the VMP for a post shave utilization use. Commercialization of this vulvar moisturizer and availability is anticipated in 2023.

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

Dr Bulent CIHANTIMUR

Plastic Surgeon

Turkey

Other author(s) : Dr. Gina Moret Nesi

Genital harmonization: a clinical experience with a combined approach

Objectives: This study aimed to provide data on our clinical experience on female genital aesthetic operations in terms of achievement of the ideal appearance, measurements and proportions of vulvar structures without losing the functional properties of the organ.

Introduction: In the literature, several surgical approaches for genital cosmetic surgeries have been identified; however, the ideal appearance of the vulva or the standards governing the ratio of structures to each other remain undefined.
We aim to share our 7-year clinical expertise with genital aesthetic procedures in terms of establishing optimal vulva size and appearance, as well as the ratio of vulvar components, without jeopardizing the organ's functionality.

Materials / method: A total of 430 patients who had genital aesthetic operations (labiaplasty, clitoral hudoplasty, labium fat filling) in our clinic, between 2013 and 2020 were included in this retrospective study. The genital area measurements were performed digitally using photographs taken before and 3 months after genital operations.

Results: According to the authors, establishing the vulvar harmonization procedure provided standards to determine the ratio of the structures to each other showing importance to the examination and analysis before the procedure as well as planning the surgery accordingly, and making preoperative marks.

Conclusion: Defining the ideal vulvar harmonization in genital aesthetic operations may provide a reference that can be used by surgeons in pre-surgical analysis and planning.

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

Dr Tinatin TOMADZE

Gynecologist

Georgia

Other author(s) : M.Sulamanidze

Modern methods in functional and aesthetic gynecology

Objectives: This review aims to evaluate perspectives in Aesthetic Gynecology.
- Mini-invasive thread lifting procedures are used for vaginal tightening, relief of postdelivery, posttraumatic postmenopausal atrophy symptoms (stress incontinence, dryness, itching, etc.),
- Narrowing of the vaginal opening, correction of Perineum, volumisation, and biorevitalisation of Labia majora, and improvement of sexual function.

Introduction: The popularity of cosmetic procedures of female genital organs has increased significantly in recent years. In the field of aesthetic gynecology, there is an increasing number of patients asking specialized doctors about this service. Mini-Invasive vaginal rejuvenation treatments provide women with an alternative to surgery that achieves results nearly as quickly. Among mini-invasive procedures such as Laser, PRP, Fillers, thread lifting has more possibility to achieve desired results due to its Composition, types, methods, and techniques.

Materials / method: Nowadays most effective, safe, and usable threads for the Genital floor are made of Absorbable poly-L-lactic acid in combination with Caprolactone P(LA/CL) with Barbs. Due to its composition threads stimulate Elastin and Collagen Type (I) and (III) synthesis into the tissues, as a result, we can improve dryness in the vagina, reduce pigmentation on the Labia majora, and rejuvenate subcutaneous fatty tissues. The barbs which are provided along the threads give us a possibility to fix, tight, and elevate tissues and superficial muscles, Armoring weakened and relaxed vaginal walls and muscles.

Results: There is a key important advantage of this product to compare separately other mini-invasive procedures, cause with thread lifting procedures we can achieve combination result what cannot be done separately with other products and devices. Thread lifting procedure in aesthetic gynecology held under Local Anesthesia. For insertion need just only one entry point without any incision or cicatrices. This entire process usually takes just 30 to 45 min. The effect can be achieved in Parous and Non-Parous women as well.

Conclusion: In Conclusion, based on our results we are encouraged that Thread lifting methods for Aesthetic Gynecology is a promising candidate for external and internal genital zone beautification and rejuvenation. due to increased interest as a result doctors implementing this method in their practice. What is important is that there are some ongoing clinical studies to provide evidence-based outcomes.

Disclosures

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

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: company

Dr Jamila ATANNAZ

Plastic Surgeon

Morocco

Other author(s) :

Wedge labia minora reduction: tips and tricks for better outcome and less complications

Objectives: At the end of this presentation the audience will learn:
Review of anatomy, histology and physiology of labia minora
Explain surgical technique of wedge labiaplasty
Tips and tricks to improve outcome
Complications and how to avoid them

Introduction: Currently, cosmetic gynecology is one of the most rapidly growing aesthetic subspecialties. Between 2011 and 2012 there have been 64% increase in the number of procedures performed in the USA according to the ASPS. Many surgeons tend to perform linear resection for fear of possibility of dehiscence. Wedge resection is superior in maintaining the function and natural look and sensation

Materials / method: We discuss the points to be considered in preoperative preparation for wedge labiaplasty surgery. As well, surgical techniques used to avoid dehiscence which is a common complication in up to 28% in the literature will be demonstrated in a video presentation

Results: Details of under local anesthesia.of the labia minora as an office procedure. Explanation of surgical tips used to visualize vascular supply and using radio-surgery with subcutaneous tissue preservation.

Conclusion: Using the proper surgical technique help to minimize labiaplasty complications especially dehiscence.

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

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IMCAS World Congress 2022 Program

FOCUS ON S086

Contributing lectures - Genital treatments

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2022
Program