Kadın Hastalarda Genital Rejuvenasyon Tecrübeleri: Epidemiyoloji, Tedavi Yöntemleri ve Hasta Memnuniyetinin Retrospektif Değerlendirilmesi

Yıl 2023, Cilt: 45 Sayı: 4, 573 - 580, 20.07.2023

Hüray Hügül , Mustafa Derda Kaya , Muazzez Çiğdem Oba , Murat Kirişci , Zekayi Kutlubay

https://doi.org/10.20515/otd.1307371

Öz

Kadın hastalarda genital bölgede kozmetik veya fonksiyonel sorunların giderilmesi için yapılan non-invazif uygulamalar son yıllarda giderek artmaktadır. Bu çalışmada amacımız genital rejuvenasyon için başvuran kadın hastaların demografik özelliklerini belirlemek, uygulanan tedavi yöntemlerinden hasta memnuniyetini ve hasta memnuniyetine etki eden faktörleri değerlendirmektir. Ağustos 2020 ile Ekim 2022 tarihleri arasında fraksiyonel CO2 lazer ile vajinal rejuvenasyon, mons pubis ve/veya labia majoralara hiyaluronik asit dolgu uygulanan ve vulvaya peeling uygulanan kadın hastaların verileri retrospektif olarak kaydedildi. Yaşları 24 ila 62 arasında değişen toplam 52 kadın hastanın çoğunluğu 44 yaş ve altında olup (n=35, %67.3), premenopozal dönemde idi (n=38,%73). Lazer uygulaması sonrası hastaların % 59.6’sı (n=31), dolgu uygulaması sonrası % 57.7’si (n=30) hissedilir ve ciddi derecelerde cinsel tatminde artış bildirmişlerdi. Dolgu ve lazer tedavilerinden sonra cinsel tatminde artış genç yaştaki hastalarda ve gravida ve parite sayısı düşük olan hastalarda; ileri yaş ve gravida ve parite sayısı yüksek olan hastalara kıyasla yüksek bulundu (tümü p< .05). Kırk (%76.9) hastada genital hiperpigmentasyonda %25 ve üzerinde düzelme kaydedildi. Düşük gravida ve parite sayısı olan hastalarda pigmentasyonda düzelme daha başarılı bulundu (p=0.02 ve p=0.018). Ayrıca tüm tedavilerde premenopozal hastaların postmenopozal hastalara göre (lazer, dolgu ve peeling için sırasıyla p=0.000, p=0.000 ve p=0.008) ve sezaryen doğum yapan hastaların normal vajinal doğum yapan hastalara göre (lazer, dolgu ve peeling için sırasıyla p=0.000, p=0.003 ve p=0.043) tedavi memnuniyeti istatistiksel olarak anlamlı yüksek bulundu. Sonuç olarak, genital rejuvenasyon amacıyla başvuran kadın hastaların özellikle premenopozal dönemde tedavilerden belirgin fayda gördükleri, gebelik/doğum sayısı ve doğum şeklinin tedaviden memnuniyeti etkileyen faktörler oldukları görülmüştür.

Anahtar Kelimeler

dermal dolgu maddeleri, hasta memnuniyeti, lazer tedavisi

Genital Rejuvenation Experiences in Female Patients: Retrospective Evaluation of Epidemiology, Treatment Methods and Patient Satisfaction

Öz

Non-invasive modalities are increasingly used for the treatment of cosmetic or functional problems in the genital area in female patients. We aimed to determine the demographic characteristics of female patients who applied for genital rejuvenation, to evaluate the patient satisfaction and the factors affecting patient satisfaction. The data of female patients who underwent vaginal fractional CO2 laser application, vulvar hyaluronic acid filler, and peeling between August 2020-October 2022 were recorded retrospectively. The majority of 52 patients (24-62 years) were ≤44 years (n=35, 67.3%), were in the premenopausal period (n=38, 73%). After laser application, 59.6% (n=31) of the patients and 57.7% (n=30) after filler application reported a meaningful and significant increase in sexual satisfaction. Increase in sexual satisfaction after filler and laser treatments was higher in young patients and in patients with low gravida/parity numbers as compared to patients with advanced age and higher gravida/ parity numbers (all p< .05). An improvement of ≥ 25% in genital hyperpigmentation was observed in 40 (76.9%) patients, which was better with lower gravida/parity numbers (p=0.02 and p=0.018). In all treatments, treatment satisfaction of premenopausal patients (vs. postmenopausal patients) was found to be statistically significantly higher (p=0.000, p=0.000 and p=0.008 for laser, filler and peeling treatments respectively) and in patients with cesarean section (vs. normal vaginal delivery) (p=0.000, p=0.003 and p=0.043 for laser, filler and peeling treatments respectively). Our study revealed that patients benefited significantly from treatments, especially in the premenopausal period, and the number of pregnancies/births and delivery method were factors affecting treatment satisfaction.

Anahtar Kelimeler

dermal fillers, laser therapy, patient satisfaction

Kaynakça

• 1. Gold M, Andriessen A, Bader A, Alinsod R, French ES, Guerette N, Kolodchenko Y, Krychman M, Murrman S, Samuels S. Review and clinical experience exploring evidence, clinical efficacy, and safety regarding nonsurgical treatment of feminine rejuvenation. Journal of Cosmetic Dermatology 2018;17: 289-97.
• 2. Jindal P, Malhotra N, Joshi S (Edited by). Aesthetic and Regenerative Gynecology In: Agarwal M, Shah SK. Non Energy Based Modalities in Cosmetic Gynaecology. Springer, Singapore. 2022; 259-264.
• 3. Hexsel D, Dal'Forno T, Caspary P, Hexsel CL. Soft-tissue augmentation with hyaluronic acid filler for labia majora and mons pubis. Dermatologic Surgery 2016;42:911-4.
• 4. Salvatore S, Nappi RE, Zerbinati N, Calligaro A, Ferrero S, Origoni M, ... & Leone Roberti Maggiore U. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric 2014;17: 363-9.
• 5. 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: 1102-7.
• 6. Adabi K, Golshahi F, Niroomansh S, Razzaghi Z, Ghaemi M. Effect of the fractional CO2 laser on the quality of life, general health, and genitourinary symptoms in postmenopausal women with vaginal atrophy: a prospective cohort. Journal of lasers in medical sciences 2020;11: 65.
• 7. Franic D, Fistonic I. Laser therapy in the treatment of female urinary incontinence and genitourinary syndrome of menopause: an update. Biomed Res Int 2019;2019:1576359.
• 8. Emerson C, Pieralli A, Bianchi C, Longinotti M, Corioni S, Auzzi N, Becorpi A, Fallani MG, Cariti G, Petraglia F. Long-term reliability of fractioned CO2 laser as a treatment for vulvovaginal atrophy (VVA) symptoms. Archives of gynecology and obstetrics, 2017;296: 973-8.
• 9. Lauterbach R, Dabaja H, Matanes E, Gruenwald I, Lowenstein L. The Efficacy and safety of CO2 laser treatment for sexual function and vaginal laxity improvement in pre‐menopausal women. Lasers in Surgery and Medicine, 2021;53: 199-203.
• 10. Toplu G, Serin M, Unveren T, Altinel D. Patient reported vaginal laxity, sexual function and stress incontinence improvement following vaginal rejuvenation with fractional carbon dioxide laser. J Plast Surg Hand Surg. 2021 ;55:25-31.
• 11. Mohammed GF, Al‐Dhubaibi MS, Mohamed ML. Genital whitening with topical Cyperus rotundus oil enhances sexuality and quality of life. Journal of Cosmetic Dermatology. 2022; 21:4490-4502.
• 12. Triana L (Edited By). Aesthetic Vaginal Plastic Surgery In: Triana L. Labia Majora Non-surgical Options: Lightening, Fillers, and Skin Tightening. Springer, Cham. 2020;193-197.
• 13. Fasola E, Gazzola R. Labia majora augmentation with hyaluronic acid filler: technique and results. Aesthetic Surgery Journal, 2016;36: 1155-63.