Dr Nicolas Berreni is a practicing obstetrician gynecologist and the co-founder and General Secretary of the Research and Innovation Group in Genital Restoration (GRIRG).

Dr Berreni chaired the Anatomy on Cadaver: vulvovaginal rejuvenation session at the recent IMCAS Asia 2017 congress in Bali. We asked him a few questions on vulvovaginal rejuvenation.

What value can gynecologists gain from attending a workshop like the Anatomy on Cadaver: vulvovaginal rejuvenation session?

Whether you are a gynecologist, plastic surgeon, dermatologist, or any other medical specialist who is interested in genital restoration, a “return to the roots”, that is to say obtaining a deep knowledge and mastery of the anatomical bases, is essential. It is essential to really understand what is being done, to give the right indications, apply the right therapeutic proposals, and to especially recognize the limits and dangers!

Over the last few years, what trends have you seen in vulvovaginal rejuvenation?

In recent years there have been many therapeutic proposals for vulvovaginal restoration! The same evolution has been observed in the genital area as in the aesthetic management of the body and, more specifically, the face.

It all began with the use of botulinum toxin, more than ten years ago, in the treatment of vaginismus, sexual problems and perineal pain.

Next, the practice of injections. Firstly, specific hyaluronic acids that were dedicated to reconstruction and vulva remodeling, but were also used in the correction of functional vaginal disorders, such as dryness or pain, that cause major sex related issues. Other injectable practices have also developed, including fat injections, lipofilling and PRP.

Finally, the arrival of instrumental techniques including lasers (CO2 / Er-YAG), radiofrequencies and, most recently, focused ultrasound (HIFU), has provided practitioners with a very wide range of therapies. These can treat disorders related to loss of vulvovaginal tone, such as vaginal relaxation and prolapse, and urinary incontinence disorders, like stress urinary leakage and incontinence by urinary urgency.

Where do you see the aesthetic gynecology industry moving in the future?

In the future the genital restoration industry will be interested in all the ages of a woman's life!

1. For the young woman who wishes to have cosmetic care (surgical or especially non-surgical) to correct a labia hypertrophy.

2. But also for the woman who, after giving birth, wishes to regain the vulvovaginal tonicity she had before her pregnancy with, safe and effective means, and which will bring her total sexual satisfaction in her relationships.

3. As well as the mature woman who will need to regain her hydration and vaginal lubrication at allow her to have a fulfilling sex life despite her age-related hormonal deficiency, or a therapeutic hormonal castration after hormone-dependent cancers.

The other major territory for exploration are the therapeutic technical proposals that, in the next few years, will allow the non-surgical and non-medicated management of the disorders of female urinary continence which affect 40% of women of all ages in their daily lives.

New non-surgical and non-drug alternatives for the management of uro-vulvo-vaginal disorders, are not only an innovation in the treatment of women's intimacy disorders, but a real Feminine revolution, identical to the arrival of contraception!

It will make it possible to free “half of the human race, women”(1) from all the constraints they undergo: vulvovaginal mutilation, cultural sexual enslavement, genital trauma after childbirth, genital pathologies related to the consequences of surgeries and mutilative chemotherapy in hormone-dependent female cancers, as well as urogenital aging related to menopause. “so that they can help free the other half”!(1)

Reference

(1) From the Human Development Report (United Nations Development Program UNDP 2013).