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HYALURONIC ACID INJECTION AS FUNCTIONAL ADJUVANT THERAPY IN
MENOPAUSAL VULVOVAGINAL SYMPTOMS. Preliminary report.
F. Bogliatto M.D., L. Leidi M.D, M. Miletta MW .
Lower Female Genital Tract Unit – Chivasso Civic Hospital. Italy
BRIEF REPORT
ABSTRACT:
Objective:Aim of the study is to evaluate the role of vulvovaginal injection of a cross-linked HA in
patients surgically treated for cancer affected by vulvovaginal symptomatology.
Methods: 23 post menopausal patients treated for endometrial cancer with vulvovaginal symptoms
were treated. We performed multiple spots injections of 1ml HA with 30Gx1/2 in needle (T1),
repeated after 3 months (T2). Self-evaluation using a visual analog scale and investigators
evaluation were recorded one month after each treatment
Results:After T1, improvement in vulvovaginal dryness, vulval itching, burning and dyspareunia
were reported. At T2, further reduction of symptoms. No side effects were recorded
Conclusions:HA injection is a new, effective adjuvant therapy of postmenopausal vulvovaginal
symptoms (above in women after cancer, with hormonal treatment not recommended)
ARTICLE:
OBJECTIVE
Hyaluronic acid (HA) gel is a valid alternative treatment to estriol cream in relieving vulvovaginal
dryness. However, topical treatments are often insufficient for a durable improvement of symptoms.
The injection of HA restores volume, rehydration and smoothing of tissues. No data are available in
genital use.
Aim of the present study is to evaluate the role of vulvovaginal injection of a cross-linked HA in
patients surgically treated for cancer affected by vulvovaginal symptomatology.
METHODS
We enrolled 23 post menopausal patients treated for endometrial cancer. Mean age was 62 years,
time since menopause was 5 years on average. Symptoms were vaginal dryness, itching, burning
and dyspareunia. After informed consent, we performed a mucous membrane multiple spots
injections of 1ml HA with 30Gx1/2 in. needle (T1) at the lower third of vaginal walls, after local
anesthesia. Treatment was repeated after 3 months (T2). Self-evaluation using a visual analog scale
and investigators evaluation were recorded one month after each treatment.
RESULTS
According to self-evaluation after T1, improvement in vulvovaginal dryness was reported by 58%
of women; improvement rates in vulval itching, burning and dyspareunia were about 75, 77, and 58
% respectively. At T2, women showed a further reduction of symptoms (82% dryness, 90% itching,
92% burning, and 78% dyspareunia). Clinical evaluation showed a trophic stimulation of mucous
membrane with a reduction of pale and atrophied appearance, and vaginal secretions in all cases.
No side effects were recorded.
CONCLUSION
In order to our preliminary results, high-molecolar weight HA injection is a new, effective adjuvant
therapy of postmenopausal vulvovaginal symptoms; it could be recommended in women operated
on cancer in which hormonal treatment is not safe. Surely, further studies has recommanded to
spread this clinical practice and to improve gynaecologists skills, respecting the health need of
patients in post menopausal period.
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