Advertisement

Female genitourinary treatments in aesthetics

      Abstract

      Female genitourinary treatments in aesthetics utilize energy-based treatments and other noninvasive modalities. These include CO2 and Erbium YAG lasers, radiofrequency, high-intensity focused electromagnetic energy, hyaluronic acid injection, platelet-rich plasma, and silicone thread treatments with an objective to treat sexual dysfunction and symptoms of genitourinary syndrome associated with menopause, which include atrophic vaginitis, urinary incontinence, and vulvovaginal laxity that is characterized by vaginal dryness, thinning of the epithelium, laxity, prolapse, incontinence, dyspareunia, and increased bacterial infections. The body of evidence is growing for the use of these modalities to improve signs and symptoms of the genitourinary syndrome associated with menopause and sexual function, as well as for rejuvenating the appearance of the external female genitalia. We reviewed the currently available modalities in this rapidly advancing area of expertise.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinics in Dermatology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Shifren JL.
        Genitourinary syndrome of menopause.
        Clin Obstet Gynecol. 2018; 61: 508-516
        • Alexiades M.
        Women's genitourinary disorders.
        in: Alexiades M Cosmetic Dermatologic Surgery. Wolters Kluwer, Philadelphia, PA2019: 746-758
        • Tadir Y
        • Gaspar A
        • Lev-Sagie A
        • et al.
        Light and energy based therapeutics for genitourinary syndrome of menopause: consensus and controversies.
        Lasers Surg Med. 2017; 49: 137-159
        • Palacios S
        • Mejia A
        • Neyro JL.
        Treatment of the genitourinary syndrome of menopause.
        Climacteric. 2015; 18: 23-29
        • Desai SA
        • Kroumpouzos G
        • Sadick N.
        Vaginal rejuvenation: from scalpel to wands.
        Int J Womens Dermatol. 2019; 5: 79-84
        • Wood LN
        • Anger JT.
        Urinary incontinence in women.
        BMJ. 2014; 349: g4531
        • Rabley A
        • O'Shea T
        • Terry R
        • et al.
        Laser therapy for genitourinary syndrome of menopause.
        Curr Urol Rep. 2018; 19: 83
        • Zerinati N
        • Serati M
        • Origoni M
        • et al.
        Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment.
        Lasers Med Sci. 2015; 30: 429-436
        • Athanasiou S
        • Pitsouni E
        • Antonopoulou S
        • et al.
        The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women.
        Climacteric. 2016; 19: 512-518
        • Salvatore S
        • Nappi RE
        • Zerbinati N
        • et al.
        A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study.
        Climacteric. 2014; 17: 363-369
        • Salvatore S
        • Nappi RE
        • Parma M
        • et al.
        Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy.
        Climacteric. 2015; 18: 219-225
        • Sokol ER
        • Karram MM.
        An assessment of the safety and efficacy of a fractional CO2 laser system for the treatment of vulvovaginal atrophy.
        Menopause. 2016; 23: 1102-1107
        • Sokol ER
        • Karram MM.
        Use of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause: 1-year outcomes.
        Menopause. 2017; 24: 810-814
        • Franic D
        • Fistonic I.
        Laser therapy in the treatment of female urinary incontinence and genitourinary syndrome of menopause: an update.
        Biomed Res Int. 2019; 20191576359
        • Adabi K
        • Golshahi F
        • Niroomansh S
        • et al.
        Effect of the fractional CO2 on the quality of life, general health, and genitourinary symptoms in postmenopausal women with vaginal atrophy: a prospective cohort.
        J Lasers Med Sci. 2020; 11: 65-69
        • Paraiso MFR
        • Ferrando CA
        • Sokol ER
        • et al.
        A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: the VeLVET trial.
        Menopause. 2020; 27: 50-56
        • Sipos AG
        • Kozma B
        • Poka R
        • Larson K
        • Takacs P.
        The effect of fractional CO2 laser treatment on the symptoms of pelvic floor dysfunctions: pelvic floor distress inventory-20 questionnaire.
        Lasers Surg Med. 2019; 51: 882-886
        • Lin KL
        • Chou SH
        • Long CY.
        Effect of Er:YAG laser for women with stress urinary incontinence.
        Biomed Res Int. 2019; 2019: 1-7
        • Gaspar A
        • Maestri S
        • Silva J
        • et al.
        Intraurethral erbium:YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause: a pilot study.
        Lasers Surg Med. 2018; 50: 802-807
        • Gambacciani M
        • Levancini M
        • Cervigni M.
        Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause.
        Climacteric. 2015; 18: 757-763
        • Lapii GA
        • Yakovleva AY
        • Neimark AI
        • Lushnikova EL.
        Study of proliferative activity of vaginal epithelium in women with stress urinary incontinence treated by Er:YAG laser.
        Bull Exp Biol Med. 2017; 163: 280-283
        • Gaspar A
        • Brandi H
        • Gomez V
        • Luque D.
        Efficacy of erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause.
        Lasers Surg Med. 2017; 49: 160-168
        • Gambacciani M
        • Levancini M
        • Russo E
        • et al.
        Long-term effects of vaginal erbium laser in the treatment of genitourinary syndrome of menopause.
        Climacteric. 2018; 21: 148-152
        • Qureshi AA
        • Tenenbaum MM
        • Myckatyn TM.
        Nonsurgical vulvovaginal rejuvenation with radiofrequency and laser devices: a literature review and comprehensive update for aesthetic surgeons.
        Aesthet Surg J. 2018; 38: 302-311
        • Gold M
        • Andriessen A
        • Bader A
        • Alinsod R
        • et al.
        Review and clinical experience exploring evidence, clinical efficacy, and safety regarding nonsurgical treatment of feminine rejuvenation.
        J Cosmet Dermatol. 2018; 17: 289-297
        • Alinsod RM.
        Transcutaneous temperature controlled radiofrequency for orgasmic dysfunction.
        Lasers Surg Med. 2016; 48: 641-645
        • Vanaman Wilson MJ
        • Bolton J
        • Jones IT
        • et al.
        Histologic and clinical changes in vulvovaginal tissue after treatment with a transcutaneous temperature-controlled radiofrequency device.
        Dermatol Surg. 2018; 44: 705-713
        • Krychman M
        • Rowan CG
        • Allan BB
        • et al.
        Effect of single-treatment, surface-cooled radiofrequency therapy on vaginal laxity and female sexual function: the VIVEVE I randomized controlled trial.
        J Sex Med. 2017; 14: 215-225
        • Leibaschoff G
        • Izasa PG
        • Cadona JL
        • et al.
        Transcutaneous temperature controlled radiofrequency (TTCRF) for the treatment of menopausal vaginal/genitourinary symptoms.
        Surg Technol Int. 2016; 29: 149-159
        • Duncan D
        • Dinev I.
        Non-invasive induction of muscle fiber hypertrophy and hyperplasia: effects of high-intensity focused electromagnetic field evaluated in an in-vivo porcine model: a pilot study.
        Aesthet Surg J. 2020; 40: 568-574
        • Alexiades M.
        High intensity focused electromagnetic field (HIFEM) devices in dermatology.
        J Drugs Dermatol. 2019; 18: 1088
        • Silantyeva E
        • Zarkovic D
        • Astafeva E
        • et al.
        A comparative study on the effects of high-intensity focused electromagnetic technology and electrostimulation for the treatment of pelvic floor muscles and urinary incontinence in parous women: analysis of posttreatment data.
        Female Pelvic Med Reconstr Surg. 2021; 27: 269-273
      1. Berenholz J, Sims T, Botros G. HIFEM technology can improve quality of life of incontinent patients. BTL document. Liverpool, UK.

        • Alinsod R
        • Vasilev V
        • Yanev K
        • et al.
        HIFEM technology-A new perspective in treatment of stress urinary incontinence.
        in: Paper presented at: 38th American Society for Laser Medicine and Surgery Annual Conference on “Energy-Based Medicine and Science. 4. Dallas, Texas2018: 11-15
        • Samuels JB
        • Pezzella A
        • Berenholz J
        • Alinsod R.
        Safety and efficacy of a non-invasive high-intensity focused electromagnetic field (HIFEM) device for treatment of urinary incontinence and enhancement of quality of life.
        Lasers Surg Med. 2019; 51: 760-766
        • Samuels J
        • Guerette N.
        HIFEM technology-The non-invasive treatment of urinary incontinence.
        in: Paper presented at: 38th American Society for Laser Medicine and Surgery Annual Conference on “Energy-Based Medicine and Science. 2018
        • Fasola E
        • Gazzola R.
        Labia majora augmentation with hyaluronic acid filler: technique and results.
        Aesthet Surg J. 2016; 36: 1155-1163
        • Hexzel D
        • Dal'Forno T
        • Caspary P
        • Hexsel CL
        Soft-tissue augmentation with hyaluronic acid filler for labia majora and mons pubis.
        Dermatol Surg. 2016; 42: 911-914
        • Aguilar P
        • Hersant B
        • SidAhmed-Mezi M
        • et al.
        Novel technique of vulvo-vaginal rejuvenation by lipofilling and injection of combined platelet-rich-plasma and hyaluronic acid: a case-report.
        Springerplus. 2016; 5: 1184
        • Hersant B
        • SidAhmen-Mezi M
        • Belkacemi Y
        • et al.
        Efficacy of injecting platelet concentrate combined with hyaluronic acid for the treatment of vulvovaginal atrophy in postmenopausal women with history of breast cancer: a phase 2 pilot study.
        Menopause. 2018; 25: 1124-1130
        • Park HJ
        • Jung KH
        • Kim SY
        • et al.
        Hyaluronic acid pulmonary embolism: a critical consequence of an illegal cosmetic vaginal procedure.
        Thorax. 2010; 65: 360-361
        • Kim SH
        • Park ES
        • Kim TH.
        Rejuvenation using platelet-rich plasma and lipofilling for vaginal atrophy and lichen sclerosus.
        J Menopausal Med. 2017; 23: 63-68
        • Vanaman M
        • Bolton J
        • Placik O
        • Guillen S.
        Emerging trends in nonsurgical female genital rejuvenation.
        Dermatol Surg. 2016; 42: 1019-1029
        • Park TH
        • Park HJ
        • Whang KW.
        Functional vaginal rejuvenation with elastic silicone threads: a 4-year experience with 180 patients.
        J Plast Surg Hand Surg. 2015; 49: 36-39