Абстракт

Objectives: To evaluate the symptoms of genitourinary syndrome (GUS), colposcopy and vaginal histopathology in pre- and postmenopausal patients treated with autologous fibroblasts (AFB). Introduction: Vaginal atrophy is associated with hormonal deficiency of both estrogen and other sex steroids. Estrogen modulates the quantity and viscosity of the vaginal mucosa and is related to the production of mucosal fibroblasts, transforming the endometrium. Its deficiency causes vulvovaginal atrophy and genitourinary syndrome. Materials / method: A cross-sectional study nested within a cohort study was conducted in 5 pre- and postmenopausal women aged 40 to 55 years (47 years, 95% CI 45-50), diagnosed with genitourinary syndrome, treated with FBA. Information on symptoms of GMS and results of colposcopy and vaginal mucosal biopsy (VMB) was collected. Results: All participants reported vaginal dryness, 80% dyspareunia, and 40% recurrent UTI. Colposcopy revealed vaginal bleeding (100%), atrophy (80%), and thinning and pallor of the vaginal wall (80%). Histology revealed low reticular density (60%), atrophy (80%), and decreased maturation (80%). Three months after treatment with FBA, symptoms of SGM and colposcopy findings improved. Histology showed a 3.6 mm increase in reticular thickness, 34% collagen, 44% reticular fibers, and a 191% increase in vascularity. Conclusion: Treatment with autologous fibroblasts reduces the symptoms of genitourinary syndrome, improves dryness, pallor, superficial thinning, and smoothing of the cul-de-sac; at the histological level, it increases reticular thickness, collagen percentage, the number of blood vessels per field, and the percentage of reticular fibers. These changes are significant at 3 months and persist up to 12 months of follow-up.