09/13/2022
NON-SURGICAL VAGINAL REJUVENATION USING CO2 LASER AND RADIO FREQUENCY ENERGY
AUG 19, 2022
Surgical va**nal rejuvenation with vaginoplasty has increased in popularity. As a surgical procedure it results in considerable down time, needs anesthesia, is expensive and may result in scar formation. With newly developed equipment excellent functional results can now be obtained with non-surgical approaches to va**nal rejuvenation. Fractional CO2 laser and radio-frequency (RF) stimulation to the va**na have been developed as non-surgical treatment of va**nal dryness and atrophy, urinary and stool leakage, or****ic dysfunction, and some women simply wish to improve the aesthetic appearance and function of the ge***al tract.
Vaginal rejuvenation may be needed both before and after the menopause. During childbearing age, multiple deliveries, delivery of a large baby, and instrumental va**nal delivery (-ies) easily distends tissue and cause va**nal tissue laxness but post cesarian section va**nal laxness can also be pronounced. The tissue laxness may result in increased urethral mobility and it is not unusual that this results in the development of incontinence, mostly with mild to moderately annoying urinary leaks during “stress” situations but may also result in leakage of stool.
A few years after the menopause, va**nal atrophy with poor va**nal lubrication and dyspareunia is a frequent development. Together with va**nal laxity, sexual dysfunctions and mild to moderate incontinence, these symptoms have collectively been called genito-urinary syndrome of menopause (GSM). The standard treatment of GSM has been systemic or local estrogen treatment. However, there are a number of contraindication to estrogen treatment such as history of breast cancer, previous thrombo-embolism, liver dysfunction and estrogen treatment may increase the risk of the development of breast cancer. It is also well known that patients are not very consistent in taking and maintaining the estrogen therapy.
CO2 laser is best used for superficial treatment of the va**nal mucosa since it penetrates only a few millimeters into the tissue. Consequently, its major application is to treat va**nal dryness and atrophy. Clinical experience indicate also that it has a major positive effect on or****ic performance. A small series of women treated with Edge One va**nal CO2 laser showed a dramatic increase in FSFI (Female Sexual Function Index) score after treatment. The FSFI score measures desire, arousal, lubrication, or**sm, satisfaction and pain.
RF energy penetrates deeper into the tissue where the intent is to heat the tissue to 40-45 °C for approximately 3- 5 minutes. This thermogenic effect liberates nitrous oxide from sensitive nerves and vessels. This then mobilizes growth factors that result in collagen contraction, neo-collagenosis and neo-vascularization. These finding are also confirmed by histological studies that show an increase in va**nal cell maturation index, increased presence of papilla, increased number of fibroblasts, elastin, and collagen. The whole process results in a thickened epithelium and stroma with a return of normal lubrication and increased strength of underlying and surrounding tissue.
Friberg Medical Associates / Friberg Fertility use NeuViva equipment for va**nal rejuvenation. NeuViva has two components, Edge One CO2 laser for more superficial procedures and Intragen Jeisys RF system for deeper tissue treatment. This means that depending on patients’ symptoms (and sometimes wishes) both instruments are always available and can be used in the most efficient way. Most clinics are only equipped with one instrument and that one will be used for all conditions when va**nal rejuvenation is performed.
