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Objectives: fat graft is gaining popularity for the treatment of vulvar lichen sclerosus thus no long term results has been published yet. the authors will present their results on log term microfatgraft rigottomy technique

Introduction: Liche sclerosus is an autoimmune disease determing tissue sclerosis and stenosis. the rational of the use of fat graft is to regenerate the tissues while the rational of percutaneous release is to divide the fibrotic tissue into multiple fibrotic bundles separated one from the other by fat clusters

Materials / method: 84 patients who underwent microfatgraft and percutaneous release with a mean follow up time of 5.4 years where studies with vulvoscopy, pre and post biopsies, psycological outcomes and life quality

Results: the results show an improving of tissue quality, quality of life and psychological outcomes on a long term follow up. No major complications was recorded as well as no cancer transformation of the vulvar tissue

Conclusion: the study demonstrate the efficacy and safety of microfatgraft percutaneous release in long term follow up

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Objectives: The primary purpose of this study was to narratively report the evidence regarding the efficacy and safety of radiofrequency and electroporation treatment as an effective therapeutic choice for genital symptoms in women suffering from VVA in a specific setting of breast cancer patient treated with tamoxifen.

Introduction: Vulvovaginal atrophy (VVA) is a chronic progressive disease involving the female genital apparatus and lower urinary tract. This condition is related to hypoestrogenism consequent to menopause onset but is also due to the hormonal decrease after and during adjuvant therapy for patients affected by breast cancer. In particular, the VVA is present also in breast cancer survivors on therapy with tamoxifen.

Materials / method: All patients, at the time of admission, were under tamoxifen treatment and had a VVA which was evaluated during a gynecological exploration, and they referred symptoms as dyspareunia, vaginal dryness, burning and itching. They were treated with a device that combines radiofrequency and electroporation: they performed 7 sessions, once a week for 7 weeks, each session was composed by 10 minutes of radiofrequency followed by 10 minutes of electroporation, both using a 2% hyaluronic acid vaginal solution (in cream or gel) on the device's handpiece. Every session lasted 20 minutes totally.

Results: As it can be seen in Figure 3, after 6 months from the end of the treatment, for some patients the perception of symptoms is slightly increased, in particular localized at the level of the vulvar fourchette, but for others they have remained constant, demonstrating that the treatment gives results even in longer time. However, after 6 months of treatment all patients continued to have a satisfactory quality of life in terms of reduction of symptoms and with a resumption of sexual activity without dyspareunia.

Conclusion: The treatment with radiofrequency-electroporation synergy is a good option for vulvovaginal atrophy symptoms in a specific setting of breast cancer patient treated with tamoxifen. All the patients increased their level of quality of life without adverse effects during and after the treatment. Long-term studies should be conducted to confirm those preliminary results.

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