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Vaginal rejuvenation by autologous PRP injection

Vaginal rejuvenation by autologous PRP injection

In recent years, regenerative medicine has flourished with a shift from the traditional approach to treatment to using the body’s own cells and substances to enhance healing. In this context, platelet-rich plasma (PRP) has been widely investigated and has played a leading role in many clinical applications.

Vaginal rejuvenation by autologous PRP injection

Dr. Adelina Popa – Dermatologist

An exact definition for PRP is not absolutely clear; it is generally viewed as a
blood derivative with a higher concentration of platelets compared to baseline levels in whole blood. Besides PRP, other terms used in the literature to describe platelet-rich preparations of peripheral blood are platelet-rich growth factors, platelet-rich fibrin matrix (PRF), PRF, and platelet concentrate (PC). Kingsley first used the term PRP in 1954 to refer to platelet concentrate during blood coagulation experiments.


Vaginal rejuvenation involves a series of regenerative treatments and procedures
applied to the vagina. These procedures can be indicated either for cosmetic reasons, but, most often, to relieve certain symptoms that appear with the passage of time and, in particular, due to the genitourinary syndrome of menopause.


The decrease in the level of estrogen hormones in hair and postmenopause can
lead to vaginal dryness, pruritus (itching sensation) at vulvar and vaginal level, decreased or lack of lubrication during sexual intercourse, pain during sexual contact (dyspareunia), involuntary loss of urine ( urinary incontinence during exertion or preceded by the imperative sensation to urinate), burning sensation or vaginal or vulvar sensation that is often, in the absence of performing the summary urine examination and urine culture, confused with the symptoms of urinary infection and treated incorrectly with antibiotics.


In most situations, if patients report these symptoms when they go to a specialist
consultation or are questioned during the anamnesis, local treatments in the form of
locally applied gels, creams or eggs will be indicated. For a number of patients, however, these treatments will lead to a partial improvement in symptoms. For others – the idea of applying a la long treatment is harder to accept. There is also a category of patients who have been operated on or treated in the past for cancers in the genital area for whom these treatments are contraindicated.


An alternative to these local treatments (and which can also be used by patients
with genital cancer in the antecedents) is the treatment with plasma enriched with
platelets applied vaginally (PRP – Plasma Rich Plateled or vampire therapy).


The procedure is free of side effects. Basically, the patient’s blood is collected,
which is then centrifuged, the plasma enriched with platelets is recovered, which is then injected at the vaginal or vulvar level. This PRP contains growth and regeneration factors that will act locally and lead to regenerative effects in about two weeks.


The procedure is performed in the office, does not require hospitalization, the
patient can immediately return to her usual activities, takes about 30 minutes, is
performed under local anesthesia and is not painful because very thin needles are used. It can be recommended following a consultation that will determine if the patient in question has indications to administer the treatment.


What is PRP?
Thrombocytes (blood platelets), along with red blood cells and leukocytes, are
natural elements of blood, with essential roles in the process of hemostasis, wound
healing and tissue regeneration. PRP therapy with concentrated platelets is based on
separating and concentrating them to much higher levels than normal, through the
process of centrifuging your own blood, after collecting it in special kits. The result is
platelet-rich plasma (PRP).


PRP is considered a new and promising treatment for some gynecological
conditions, especially for those that do not currently have very effective conventional treatments, but also for more subtle problems, such as sexual dysfunction or decreased genital trophicity.


PRP, the therapy based on plasma rich in blood platelets, is a minimally invasive
method of vaginal rejuvenation. This combats the changes that occur with birth,
hormonal changes and/or the natural aging process.


Biology – PRP Science
The biological rationale for the clinical use of PRP lies in the local delivery of
growth factors (GF), cytokines, chemokines, proteins and mediators – in physiological proportions – that contribute to tissue healing and regeneration. This series of bioactive molecules is secreted by three types of granules (alpha, delta and lambda) located inside platelets.


Granule-secreted GFs include platelet-derived growth factor (PDGF), epidermal
growth factor (EGF), insulin-like growth factor (IGF), transforming growth factor β
(TGF-β), vascular endothelial growth factor (VEGF ), hepatocyte growth factor (HGF)
and fibroblast growth factor (FGF), which are involved in various mechanisms, including enhancing anabolism, bone and vessel remodeling, cell proliferation, angiogenesis, inflammation control, coagulation, and cell differentiation. Alpha granules are also a source of cytokines, chemokines, and proteins involved in stimulating chemotaxis, cell proliferation and maturation, modulating inflammatory molecules, and attracting leukocytes. Delta granules contain ADP, ATP, calcium, magnesium, adenosine and bioactive amines such as serotonin, histamine and dopamine. Lambda granules are the least studied; their main role is to remove cellular debris and infectious agents.


In addition, plasma itself contains molecules involved in the healing mechanism of
connective tissues.


PRP in vaginal rejuvenation
PRP is used to regenerate the vaginal mucosa. After PRP injection, vaginal
vasculature and trophicity are improved, with a subsequent dramatic increase in
sensitivity. Studies show that the application of intravaginal PRP in patients with
postmenopausal vaginal atrophy produces relief of symptoms and restoration of
trophicity of the vaginal mucosa, with a certain improvement in the quality of life. In
addition, the vaginal mucosa becomes thicker and firmer, which makes the vagina appear younger, as reported by Kim et al using PRP in a case of vaginal rejuvenation. The revitalized appearance of the external genitalia provided the patient with a pleasant cosmetic result.

See Also


PRP in urinary incontinence
Stress urinary incontinence (SUI) is a major health problem, affecting
approximately 20% of adult women and having a detrimental impact on daily activities and quality of life. Stress urinary incontinence occurs frequently in women after childbirth. If conservative treatment such as pelvic muscle strengthening exercises (Kegel exercises) or medical treatment fails, then surgical interventions to restore urinary continence (suburethral polypropylene banding, periurethral filler injection, or artificial sphincter implantation) they become necessary for patients with moderate and severe disease. Most surgical techniques are associated with a variety of intraoperative and postoperative complications. Patients with mild urinary incontinence may not accept active surgical treatment due to its risks. Autologous platelet-rich plasma (PRP) therapy is growing in popularity as a non-surgical therapy in mild SUI. The main cause of UTI in women is the weakening of the pubo-urethral ligament, the ligament that fixes the urethra in the correct position to the pelvic bones. This ligament is progressively damaged with each birth. Studies based on the injection of PRP in the mild clinical form of SUI, in the one that is refractory to the currently available medical treatment, and in the one that has relapsed after surgical therapy, confirm the improvement of urinary continence and the quality of life of the patients.


PRP in sexual dysfunction
PRP therapy is considered to be a revolutionary new, non-surgical treatment that
helps improve sexual function. PRP is injected into the clitoris and the Grafenburg area of the vagina (G-spot). PRP immediately activates tissue regeneration and the improvement in sexual response is spectacular. The desired effect includes decreased dyspareunia (pain during intercourse) and increased natural lubrication, which induce improved arousal and stronger orgasm.


PRP in vulvar atrophy/dystrophy
PRP is used in many dermatological and autoimmune conditions that affect the
region of the external genitalia (labia majora and minora, vaginal introit, clitoris). The
best known are lichen sclerosus, vulvar kraurosis, vulvar eczema, which are more
common in postmenopausal women. The symptomatology is distressing and is
manifested by sensations of vulvar dryness, progressive itching, dyspareunia and genital bleeding. Lichen sclerosus vulvar causes extensive scarring with progressive atrophy of the labia minora, clitoris and urethral meatus area. These conditions have a considerable impact on the patients’ quality of life through distressing symptoms, disruption of physical activity, sexual pleasure and induction of emotional and psychological problems.
Initially, this type of condition is treated with local and systemic corticosteroids. Topical estrogen therapy improves quality of life, but the effectiveness of these treatments decreases over time.


Mode of action
Its unique properties have made PRP therapy used in anti-aging medicine,
contributing significantly to the rejuvenation of the skin of the face or body.


Platelet-rich plasma is purified from the patient’s own blood cells. The preparation
of plasma is done in a medical centrifuge device, with the aim of producing up to 5-10 times higher concentration of platelets. This results in a product that is 100%
biocompatible and poses no risk of rejection or allergy.


Blood plasma is a serum that contains platelets, vitamins, hormones, mineral salts
and other factors essential for cell survival. Platelets in plasma synthesize about thirty bioactive proteins, with the role of growth factors. They initiate a series of natural tissue regeneration and healing mechanisms, stimulating the production of collagen and elastin.


Bibliography

  1. Vasileios Sanoulis, Nikolaos Nikolettos, Nikolaos Vlahos. The use of Platelet-Rich Plasma in the Gynaecological Clinical Setting. A review. HJOG, 18 (3), 55-65, 2019.
  2. SeokHwan Kim, EunSoo Park, TaeHee Kim – RejuvenationUsingPlatelet-rich Plasma andLipofilling for Vaginal Atrophyand Lichen Sclerous. Journal of MenopausalMedicine, 2017.
  3. Barbara, F. Facchin, L. Buggio, D. Alberico, M.P. Frattaurolo, A. Kustermann – Vaginal rejuvenation – Currentperspectives. Int J Women s Health. 2017.
  4. Jiang Y, Lee P, Lee Y, Kuo H – Urethralsphincterinjections of platelet-rich plasma (PRP) in treatment of urinary incontinence due to intrinsicsphincteric deficiency refractory to conventional treatment. ICS 2019
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