PEER-REVIEW | RADIOFREQUENCY |
TEMPERATURE CONTROLLED RADIOFREQUENCY FOR
VULVOVAGINAL LAXITY
Red M. Alinsod evaluates the results of his study on the effectiveness of non-invasive transcutaneous temperature controlled radiofrequency for vulvovaginal rejuvenation
ABSTRACT Objective: To evaluate the safety, tolerability, and clinical efficacy of non- invasive transcutaneous temperature controlled radiofrequency (TTCRF) for vulvovaginal rejuvenation and document ancillary beneficial effects of treatment.
Patients and methods: subjects (n=23; age range 26–58 years, mean 43.6; 5 menopausal, 6 perimenopausal) presented with mild to moderate primary or secondary vulvovaginal laxity. Associated conditions (orgasmic
labia majora, is even more skin-like although generally more heavily vascularized and innervated than skin in most bodily regions. During vaginal delivery, stretching causes damage to the connective tissue that heals in a varying state of laxity that increases with each successive birth; the vulva is similarly affected. In addition, reductions in the quality of connective tissue due to neuroendocrine changes and age serve as contributing factors. This condition is rarely discussed in a clinical setting1–3
T 16 . Other conditions such as stress
incontinence and atrophic vaginitis arise in conjunction with vulvovaginal laxity, as well as natural results of delivery trauma and advancing age. An additional consequence to vulvovaginal laxity is reduced sensation during coitus, with a potential negative effect on sexual satisfaction and quality of life4–7
. The term ‘vulvovaginal laxity’, encompasses laxity of
both the vaginal introitus and labia majora. Given that most people refer to the entire compound structure as ‘the vagina’ it stands to reason that ‘vaginal laxity’ and
KEYWORDS Vulvovaginal laxity, temperature-controlled radiofrequency, non-surgical vaginal rejuvenation
August/September 2015 |
prime-journal.com
dysfunction, stress incontinence, atrophic vaginitis) were present in most subjects. Exclusion criteria included pelvic surgery within 5 years, pregnancy or planned pregnancy within the study period, recent abnormal Papanicolaou test result, and presence of vulvar lesions or any condition that may potentially interfere with the safe treatment. Informed consent was obtained from all subjects. Patients were treated up to three times at an interval of 4 to 6 weeks.
Outcome measures: subject assessment via vaginal laxity questionnaire (VLQ)
HE VAGINAL WALL PREDOMINANTLY consists of dense connective tissue that is heavily vascularized and through which many nerves pass, lined by a slightly keratinized, stratified squamous epithelium. The vulva, particularly the
rating on a 7 point scale where 1=very loose and 7=very tight, and sexual satisfaction questionnaire (SSQ) rating on a six point scale where 1=none and 6=excellent, as well as observations of associated conditions such as incontinence, atrophic vaginitis, and orgasmic dysfunction.
Results: median improvement of 5 points on the VLQ scale and 2.5 points on the SSQ scale were noted; results were
statistically significant (p<0.05).
The most pronounced outcomes manifested after initial treatment with
additional improvement after each of the second and third treatments. Patients with orgasmic dysfunction, stress incontinence, and/or atrophic vaginitis noted substantial improvement regardless of number of treatments. Menopausal subjects were able to cease usage of vaginal estrogens.
Conclusion: TTCRF is safe, tolerable, and effective for vulvovaginal rejuvenation. Evidence suggests applications in the treatment of atrophic vaginitis, orgasmic dysfunction, and stress incontinence
‘vulvovaginal laxity’ will be used synonymously by some but it is important to note that, technically, ‘vaginal laxity’ does not involve the vulva specifically. Laxity of the vagina, specifically, is often referred to as pelvic organ prolapse but that term is also inaccurate because it refers to a more severe condition possibly involving vaginal and other genito-pelvic structures bulging into the vaginal canal and introitus, rather than laxity of the introitus itself8
.
RED M. ALINSOD, M.D., FACOG, FACS, ACGE, South Coast Urogynecology, 31852 Coast Highway, Laguna Beach, CA 92651
email:
red@urogyn.org To the patient, there are other notable characteristics
of vulvovaginal laxity and the aesthetic appearance of the vagina may be perceived as significantly compromised, leading to self-consciousness. Laxity of the labia majora may be associated with discomfort and irritation when tight clothing is worn, as well as discomfort during intercourse. Orgasmic dysfunction, reduced friction during sex due to ‘looseness’, and other aspects of laxity-related changes are perceived to negatively impact the sexual experience in a variety of ways. So vaginal laxity or ‘looseness’ as a medical or aesthetic concern is not new; it is, however, only recently becoming socially acceptable as a topic of consideration. References to the vagina—structure, function, and associated problems—are now less taboo. Gynecological and urological issues that women may have been reluctant to address directly with physicians or even friends in the
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