Fat grafting injections for the treatment of vaginal atrophy, vulvar dermatoses, and stress urinary incontinence.

Authors: Soraya Koushesh, Angela Cullen, Shohreh Beski

Objective

Vaginal atrophy, vulvar dermatoses, and stress urinary incontinence (SUI) are common conditions in women that can have detrimental effect on urogenital health, sexual function, and psychological wellbeing. They can occur at any time during a woman’s life, but they prevail in postmenopausal women.

Current treatments require ongoing management associated with risks and complications and often inadequate symptoms relief. Local injection of autologous micro-fragmented adipose tissue is well established as a safe and effective treatment with several clinical applications. The aim of this observational case series was to evaluate the effectiveness and safety of autologous micro-fragmented adipose tissue injections for the treatment of vaginal atrophy, vulvovaginal dystrophy, and SUI in women.

Methods

Thirty-eight women affected by vaginal atrophy, vulval dermatoses and/or SUI were injected into their affected areas with harvested and processed autologous micro-fragmented adipose tissue. Outcomes were measured using the Female Sexual Function Index (FSFI), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), the Vulvovaginal Symptoms Questionnaire (VSQ), and the Short-Form 12 (SF-12) health survey. Information gained from discussion and clinical examination at consultations was also used to measure outcomes.

Results

No adverse events or complications were reported during the intraoperative recovery, postoperative, or follow-up periods. No signs of infection, pain, dysuria, skin irregularities, skin discolouration, discharge, or worsening of symptoms were reported. Thirty-six out of thirty-eight women reported an improvement of symptoms within 6-24 months of follow-up period in all treated areas to lesser or greater extent. Two women with underlying lichen planus did not report improvement of symptoms following procedure.

Conclusion

The use of autologous micro-fragmented adipose tissue is promising. The treatment appeared to be safe and effective in relieving symptoms and treating physical signs of vaginal atrophy, vulval dermatoses and/or SUI.

Shohreh Beski

Consultant Obstetrician and Gynaecologist with over 35 years of experience and worked both privately and for the NHS. She has a vast amount of experience in all aspects of women’s health and has a special interest in subfertility, regenerative medicine, high-risk gynaecology, vulvar dermatoses, and menopause.