Абстракт

Objectives: Recurrent fissures affect women at all stages of life and represent a very common complaint in gynecological practice. This involves a highly sensitive mucosal area, influenced by hormonal fluctuations and subject to direct local trauma during sexual intercourse and other everyday habits. It remains a significant challenge in gynecological treatment and deserves attention from regenerative medicine, including the application of advanced technologies Introduction: The use of PDRN in facial and body regenerative treatments has been well established for several years. Redirecting this compound to the intimate area, with a focus on its regenerative potential, has shown promise in the treatment of recurrent fissures — a significant challenge in gynecological practice. The activation of adenosine A2A receptors plays a key role in modulating inflammation and enhancing local angiogenesis, both of which are crucial for the recovery of progressive fibrosis in this region. Materials / method: A total of 20 patients, with no prior treatment, were treated and followed over a 12-month period. Three applications of 1 ml of the product were administered in the vaginal fourchette, with 30-day intervals between each session. Patients were instructed to avoid sexual intercourse during the first 10 days following each application. All participants were advised to maintain their usual sexual habits, including those previously associated with the onset of fissures. After the three applications, patients returned for follow-up evaluations at 6 and 12 months to assess the outcomes. Results: Of the 20 patients who began treatment, 18 completed follow-up. Two discontinued after the first session. A 4-item questionnaire was applied at both follow-ups, assessing fissure frequency, pain during penetration, healing time, and treatment satisfaction. All patients reported improvement in at least two items. All noted reduced pain during intercourse, and 8 had complete symptom resolution. One patient was dissatisfied, despite reporting reduced pain and faster healing. Conclusion: PDRN has demonstrated promising results in the regenerative treatment of recurrent vulvar fissures, a frequent and challenging condition in gynecological practice. Its mechanism of action, primarily through A2A adenosine receptor activation, contributes to reduced inflammation, enhanced angiogenesis, and accelerated tissue repair. Clinical follow-up showed consistent improvement in pain, healing time, and overall patient satisfaction. Importantly, no adverse effects were observed, reinforcing the safety of PDRN even in mucosal applications.