Objectives: Vulva Vagina Regeneration in 2023. Biostimulation vs EBD or Biostimulation + EBD? Which is the best choice for the patients?
Dr. Gustavo H Leibaschoff
The vulva vaginal regeneration or biostimulation involves a group of procedures that improve anatomy and vulva vaginal functionality to improve aesthetics or achieve more pleasurable sex. External vaginal procedures are defined as those performed on the female genitalia outside the vaginal introit, with important structures such as the labia Majora, Mons pubis, labia minora, clitoris hood, and introitus. Internal vaginal procedures are defined a

Introduction: The prevalence of elective vaginal vulva regeneration procedures has increased in recent years, a trend that can be attributed to increased exposure through the media, including television reality and pornography. In a survey of 482 women undergoing aesthetic gynecology treatments, almost all had heard of "rejuvenation" procedures in the past 2.2 years, and 78% had received information through the media.
In addition, genital self-image can considerably affect sexual behavior and relationships. Genital dissatisfaction has been associated with decreased sexual activity, while po

Materials / method: They can present as patients who suffer from GSM Symptoms (Dryness, Itching, Burns, Dyspareunia ) because of a history of breast cancer who cannot take estrogen and have symptoms of GSM, or patients with vaginal relaxation syndrome VRS or patients with pelvic irradiation or under chemotherapy with symptoms of dryness, or patients on medication with antiestrogens or aromatase inhibitors with GSM symptoms, or Breast-feeding patients with dryness in vagina or dyspareunia or Patients with orgasm disorders because the problems of lubrication in the vagina, can be treated satisfactorily with the use

Results: of the various scientifically endorsed therapeutic techniques.
The big question of 2023 is whether it is necessary to use only one equipment of EBD, call it Laser, radio frequency, or HIFU, or according to the pathophysiology of aging that leads to vulva vaginal atrophy, it is necessary to associate other types of treatments.

Conclusion: It is my opinion today that to make a treatment for vulva vaginal regeneration; we need to use first biostimulation with PRP and nano fat w/wout micro fat and then use any device of EBD like a laser, HIFU, or radio frequency.
The combination of PRP, nanofat, micrograft, and transcutaneous carboxytherapy achieves the biostimulation of the affected tissues.
On the other hand, the use of EBD in isolation may not meet the bio-regeneration conditions, so I believe that the therapeutic association of EBD equipment plus biostimulation treatment techniques is the best for the patients

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Objectives: Share the safety and efficacy of Lyophilized Exosomes of Rosa Damascena (hMSC) as a novel treatment in Lichen Sclerosus.
Measure quality of life test (QOL) clinical symptoms and signs , histopathology changed before and after treatments and elastography changed in the tissue by advanced ultrasound.

Introduction: Lichen sclerosus (LS), formerly called lichen sclerosus et atrophicus, is a chronic inflammatory disease of the skin, characterized by the presence of papules or atrophic, white plaques of unknown etiology, which primarily affects post-menopausal women. Prevalence in the general population is estimated at 1 of every 300-1000 individuals. There may be extragenital lesions, but most appear in the genital area.

Materials / method: Exosomes are nano-sized vesicles that serve as mediators for cell-to-cell communication. With their unique nucleic acids, proteins, and lipids cargo compositions that reflect the characteristics of producer cells, exosomes can be utilized as cell-free therapeutics.
The clinical cases received exosomes ASCEplus IRVL into the vulvar area after microneedles fractional radiofrequency .
Measure quality of life test (QOL) clinical symptoms and signs and histopathology changed before and after treatments.
Elastography shearewaves by advanced ultrasound used at the 6th month to assess the quanti

Results: One month after treatment, the pruritus degree, skin color, lesion scope, and total score decreased.
After six month the signs and symptoms of the skin had disappeared and the tissue measured with quantitative elastography had gained in elasticity.
The quality of life test applied at 6 months had increased.

Conclusion: The exosomes (ASCEplus IRVL) applied after the use of energy (fractional radiofrecuency) in the tissue seems to be a good regenerative therapy in these pathologies.
No adverse effects or complications were evaluated or reported during this study .

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请注明日期: EN PROCESO
和审阅情况: DICIEMBRE 2023

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Objectives: the use of AI in aesthetic and functional gynaecology may definitely be of great importance for this enormously growing field of medicine. This combination of field could be extremely important for the entire developing of a new emerging medicine field with the use of AI for the first time in medicine history.

Introduction: Aesthetic and functional gynaecology have become increasingly popular among patients over the past years. Despite the rapidly growth of interest, scientific literature is partially lacking in this field (especially regarding the cosmetic aspect). This issue has gained so much attention from clinicians that diagnostic tools and treatment protocols need to be validated through the evidence-based medicine approach.

Materials / method: On this regard, aesthetic and functional gynecology, for its novelty, can introduce ChatGPT in the development of this field from the early beginning. Specifically, aesthetic and functional gynecology could be the first medical specialty entirely developed with the help of AI in order to achieve better evidence in a faster method.

Results: On this regard, aesthetic and functional gynecology, for its novelty, can introduce ChatGPT in the development of this field from the early beginning. Specifically, aesthetic and functional gynecology could be the first medical specialty entirely developed with the help of AI in order to achieve better evidence in a faster method.

Conclusion: AI may also be able to calculate, according to the model, the potential risks of the treatment, making this field of gynaecology safer. Patients’s outcome may improve with more accurate, personalized and precise tools helping physicians in making the right therapeutic choice and avoiding complications.
Also, given the poor literature on cosmetic gynecology, the terminology and outcome measures utilized are heterogeneous.

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