Genitourinary Disorders

Genitourinary Syndrome of Menopause (Vulvovaginal Atrophy)

In moderately severe cases of postmenopausal vulvovaginal atrophy, women often suffer from vaginal dryness, vulvovaginal irritation, vaginal discharge (atrophic vaginitis), introital dyspareunia, and perineal tearing.
This results from thinning of the epithelial lining which becomes brittle and easily irritated. In mild cases, long-term therapy with oral or local estrogen supplementation is helpful. In moderate to severe cases, or in patients who can't use hormonal therapy, PRP in conjunction with local fractional laser therapy, stimulates the growth of the epithelial lining and vaginal wall, with often immediate and long-term improvement.

The most important cause of true urinary stress incontinence is a defect in the pubourethral ligaments resulting from childbirth, aging, and congenital collagen defects.
Localized injections of PRP into the periurethral space (area between the vaginal wall and urethra) has been shown to effectively help correct the vesico (bladder)-urethral angle in the same way as a surgical sling guides. This results in the control of urinary stress incontinence associated with hypermobility of the urethra.
There is often an immediate improvement in urinary incontinence, due to the volume effect of the PRP. This may dissipate over a few days and then slowly improve again over the next three to five weeks, with full effect achieved at around three to five months. Review of the literature for this procedure, reveals a 65% success rate with one treatment which increases to 85-90% satisfaction after two treatments.