Vaginal laxity (VL) and genitourinary syndrome of menopause (GSM), as well as aesthetic changes in the vulvar skin, often occur together and cause physical, psychological, and functional problems for women and their partners. The current study evaluated the efficacy of a nonsurgical radiofrequency device (RF) procedure combined with hyaluronic acid (HA) injection into the skin of the labia majora on clinical, histological, and aesthetic levels. Twenty women with GSM and VL, aged between 36 and 72 (mean age 53.4), were treated with bipolar RF SECTUM, vaginal and vulvar application, as well as with a hyaluronic acid (HA) injection into the skin of the labia majora. The Vaginal Laxity Questionnaire (VLQ), Vaginal Health Index (VHI), and Female Sexual Function Index (FSFI) were used to examine the clinical effects of the operations. The Global Aesthetic Improvement Scale was utilized to measure patient satisfaction. On a histochemical level, the concentrations of elastin and collagen in the vaginal wall and vulvar skin were examined. Results: There was significantly higher patient satisfaction and a considerable clinical improvement across all areas of analysis. On the histochemical level, elastin and collagen fiber concentration increased after the treatment protocol both in the vulvar skin and in the vaginal wall: elastin in the vaginal wall, 11.4%, and in the vulvar skin, 61%; collagen in the vaginal wall, 26%, and in the vulvar skin, 27%. The current study demonstrated the efficacy and safety of this nonsurgical RF procedure combined with a hyaluronic acid (HA) injection into the skin of the labia majora on clinical, histochemical, and aesthetic levels.

Vaginal laxity (VL) and genitourinary syndromes of menopause (GSM) create physical, psychological, and functional problem for women and their partners. We aimed to evaluate the efficacy and safety of micro-focused ultrasound (MFU) therapy performed twice in the vaginal canal in a patients with VL and GSM. A total of 20 women with GSM and VL were treated with MFU Ultravera by Hironic. The treatment course consisted of two vaginal applications of MFU at an interval of 6 weeks. The clinical effects of the protocol were evaluated using the Vaginal Laxity Questionnaire (VLQ), the Vaginal Health Index (VHI), and the Female Sexual Function Index (FSFI). The overall values of the vaginal laxity evaluation for the total subject population showed a statistically significant improvement between the baseline and the findings at 3 and 6 months after treatment. The effect of therapy was consistent across all domains of FSFI. It peaked at the 6 week follow-up visit (from 26.5 to 32) and plateaued at 12 weeks and 6 months. There was a significant VHI improvement over time, with the greatest and most significant change between the study entry and 21 days after treatment; the VHI score leveled off up to 3 months after the procedures. MFU therapy, performed twice in the vaginal canal, showed promising efficacy and safety profiles, meriting further investigation.

Background: Stress urinary incontinence (SUI) causes both physical and psychological problems to women and their partners. Recently, vaginal radiofrequency (RF) application, as well as the administration of non-crosslinked hyaluronic acid (NCLHA) together with calcium hydroxyapatite (CaHA), has attracted attention for SUI treatment. The current, comparative study evaluated the efficacy and safety of these technologies acting separately and in a combined treatment. Methods: Sixty women with mild to moderate SUI, aged between 46 and 76 years (mean age 63.2) were divided into three groups intended for different treatments: group I, RF vaginal treatment only, group II, NCLHA plus CaHA periurethral injection only, group III, combined treatment including a single periurethral injection of NCLHA plus CaHA followed by four vaginal applications of RF at intervals of 3–5 days. The clinical effects of the treatments were evaluated by ICIQ-LUTSqol (Polish version) and UDI-6. Results: The obtained results suggest that the symptoms of SUI and the quality of life of the patients improved significantly in each group after the therapies compared to the pre-treatment levels and were more persistent in the third HA + RF group compared to the HA or the RF group.

Epigenetic dysregulation is increasingly recognized as an important contributor to ovarian carcinogenesis, and may provide novel diagnostic and prognostic biomarkers. This study evaluated DNA methylation and mRNA expression of SEPT9 and AKR1B1 in ovarian cancer and benign ovarian lesions and assessed their clinical significance. Tissue samples were obtained from 27 patients with ovarian cancer and 29 patients with benign ovarian lesions. DNA methylation was analyzed by pyrosequencing and mRNA expression by real-time PCR. Associations with clinicopathological variables, serum CA125 and HE4 concentrations, diagnostic performance, and survival outcomes were evaluated. Receiver operating characteristic (ROC) analysis, multivariable logistic regression, Kaplan–Meier analysis, and Cox regression models were performed. Multiple testing was controlled using the Benjamini–Hochberg false discovery rate procedure. Ovarian cancer tissues demonstrated significantly lower SEPT9 methylation (q = 0.008), higher AKR1B1 methylation (q = 0.0008), and lower AKR1B1 mRNA expression (q = 0.035) compared with benign ovarian lesions. SEPT9 methylation showed the highest diagnostic accuracy (AUC = 0.741). Both SEPT9 methylation (OR = 0.92, p = 0.014) and AKR1B1 methylation (OR = 9.69, p = 0.008) remained independently associated with ovarian cancer after adjustment for age and menopausal status. Low AKR1B1 mRNA expression was associated with shorter progression-free survival (p = 0.0007). These findings indicate that SEPT9 methylation and AKR1B1 dysregulation are associated with ovarian cancer. SEPT9 methylation demonstrated the best discriminative ability among the evaluated biomarkers. Further validation in larger independent cohorts is warranted.

Hymenoplasty, or the surgical restoration of the hymen, is one of the least described vulvovaginal procedures in plastic surgery, without any surgical standard that attempts to restore the hymen's ability to bleed during sexual intercourse on a couple's wedding night [1,2]. Although controversial from an ethical and social perspective, hymenoplasty is now offered in many countries [3], and its demand is increasing in Western countries, especially after successive waves of immigration. According to the BBC, hymenoplasty has gained popularity in recent years, especially among young women. Private clinics that offer the procedure, which is legal in the United Kingdom, do not collect data on the number of women who have undergone the procedure, but it is estimated that approximately 9000 women searched for the procedure on Google in 2019. Mohammad Masood, Director of MAS Gynecology Clinic in London, said in the British newspaper Metro that the number of women seeking the procedure had quadrupled compared to the previous 6 years [4]. <!----> <!----> <!----> <!---->

The aim of the study was to evaluate the concentration of collagen and elastin fibers, the number of fibroblasts/fibrocytes and vessels, as well as depth of action in the vaginal wall in a swine model before and after intravaginal 480 kHz bipolar radiofrequency heating created by a 360-degree intravaginal applicator (Berger and Kraft Medical). Three swine’s were treated with a bipolar radiofrequency vaginal probe. Exposure to RF was administered twice, every 4 weeks, and then the vaginas were removed after slaughter, four weeks after the last RF exposure. Histology specimens were obtained from control and exposed areas. Tissue samples were stained by hematoxylin-eosin, orcein, and Mallory trichrome. The concentration of elastin and collagen fibers increased distinctly after a treatment protocol: elastin, on average, was 52.8%, and collagen, on average, was 103.6%. After the treatment protocol, we revealed a significant dispersion of fibroblasts-fibrocytes nuclei for particular animals in segmented areas, with a slightly marked falling trend. A degree of data variability cannot lead to a conclusion concerning the influence of RF heating on several vessels in evaluated areas. The depth of action of the RF heating, measured by collagen concentration, reached up to 1.3 mm of the vaginal wall thickness. Results imply that heating of the vaginal wall, created by radiofrequency, induces neocollagenogenesis and neoelastogenesis, leading to a distinctive rise of collagen and elastin fibers concentration at a depth of up to 1.3 mm of the thickness of the vaginal wall in the animal model.