Clinical Significance of Topical Spermidine Hyaluronate in Vestibulodynia: An Early Appraisal

Background: The most common subtype of chronic vulvar pain is provoked vestibulodynia. The entry of the vagina is the site of acute and recurrent pain in this highly prevalent and debilitating condition, which is characterized by pressure application or attempted vaginal penetration. The aim of this study was to determine the effectiveness of topical spermidine in patients with vestibulodynia. Methods: Topical gels containing spermidine in hyaluronate complexes Ubi1 and Ubi2 endowed with differentiated release ratio and viscosity were applied at 3 doses/week during 4-weeks, then at 2 doses/week during the next 4-weeks in two groups of patients. Pain relief was measured by visual analogic score (VAS) and dyspareunia score expressed as percent improvement from baseline to posttreatment. Results: Group 1 treated with Ubi1 provided improvement in pain (46%) and dyspareunia (27%). However, the treatment in Group 2 resulted in a superior amelioration: VAS of pain (76%) and dyspareunia (50%) as Ubi2 gel provided higher dose and viscosity along with improved local application. Conclusions: Our results demonstrated that preparation 2 resulted in greater reduction in symptoms as compared to preparation 1 as measured by the VAS and Marinoff scale. These early, yet outstanding clinical outcomes in vestibulodynia through to the stimulation of tissue mechanosensor and their relevant downstream effects are reviewed hereafter.

Evaluation of an Orally Administered Multistrain Probiotic Supplement in Reducing Recurrences Rate of Bacterial Vaginosis: A Clinical and Microbiological Study

Background: Bacterial vaginosis (BV) is the most common urogenital disease in women, affecting about 19% - 24% of them in reproductive ages annually and after treatment, a single recurrence or more may occur in up to 58% of women within 12 months. Objective: The aim was to evaluate the effectiveness of a new orally administered food supplement, containing different probiotic strains, on women of childbearing age after the antibiotic treatment when compared with no probiotic intake. Methods: A prospective study was undertaken on 62 patients with BV. All patients were cured with metronidazole vaginal formulations (5 g of 0.75% gel once daily for 5 days or 500 mg ovules once daily for 7 days), then after was offered the option of using a new an orally administered food supplement containing: Lactobacillus plantarum PBS067, Lactobacillus rhamnosus LRH020 and Bifidobacterium animalis lactis BL050, with a total viability of 3 × 109 CFU/capsule (Intimique®Femme). Among these women, 50 accepted to use the new orally food supplement, while 25 patients decided to use only metronidazole (control group). Results: The recurrence rate of BV after treatment with Intimique®Femme was about 16%, compared to 40% in the control group. The incidence of abnormal vaginal microbiota decreased in both groups, but it was significantly higher in the Intimique®Femme group at the end of treatment. Conclusion: This study showed that, in case of BV diagnosis, the complementary treatment of a strain-specific probiotic complex after antibiotics prophylaxis, is mandatory to reduce potential recurrences and cyclic use of further antibiotics.

SilTech: A New Approach to Treat Aerobic Vaginitis

Background: The aerobic vaginitis (AV) is characterized by increased levels of aerobic bacteria, vaginal inflammation and depressed levels of lactobacilli. Objective: The purpose of this study was to investigate the therapeutic efficacy of SilTechTM vaginal softgel capsules, containing new microcrystals of silver monovalent ions, for aerobic vaginitis (AV). Methods: This prospective study enrolled 32 women diagnosed with AV. All recruited women were treated with SilTechTM vaginal softgel capsules once daily for 7 days (one course). Therapeutic efficacy was evaluated based on clinical and microscopic criteria, and cure rates were calculated. Women who were improved (but not cured) received a second course of therapy. Patients classified with clinical and microscopic failure were treated using other strategies. Results: After one course of therapy, 59.2% (19/32) of women were cured, 19.0% (6/32) were improved (but not cured) and 21.8% (7/32) failed to respond to the therapy. After two courses of therapy, clinical improvement was achieved in additional two women. The therapy was very well tolerated, and during the entire study no drop out related to the SylTechTM vaginal capsules treatment was observed;only two patients (6.2%) experienced a mild transient burning after application. Conclusion: SylTechTM vaginal capsules is an effective therapeutic option for patients with AV, and most women with AV were cured with one course of therapy.

Effective Treatment of Vulvar-Vaginal Complaints in Women Taking Combined Oral Contraceptive with a New Medical Device in Gel: A Pilot Study

Objective: To assess efficacy and tolerability of a new medical device in gel based on the synergic combination of NioskinTM Red Clover Extract noisome (NRC) and SylTechTM system (SB), a complex of silicium microcrystals covalently bound with silver ions associated with hyaluronic acid to the treatment of vulvo-vaginal dryness and dyspareunia in women taking combined oral contraceptive (COC). Methods: Forty eight women were treated for 12 weeks with NRC + SB vaginal gel (0.75 g/day) for 3 weeks. After therapy, symptoms (dyspareunia and dryness) were evaluated through a 10-cm VAS. Visual examination of the vagina and vulvar vestibule was also conducted, which included observations for petechiae, pallor, friability, dryness, and redness in the mucosa. Ratings were based on a 4-point scale (0, none;1, mild;2, moderate;3, severe). Results: NRC + SB vaginal gel appears to be effective for relief vulvo-vagianl dryness and dyspareunia and an improvement of vaginal and vestibular trophism was noted. Conclusion: NRC + SB vaginal gel proved good treatment options for relief of vulvovaginal symptoms in women who take COC.

Solid State Vaginal Laser for the Treatment of Genitourinary Syndrome of Menopause: A Preliminary Report

Background: Genitourinary syndrome of menopause (GSM) is the new term for vulvovaginal atrophy (VVA). The condition is relevant in more than 50% of women, having an adverse impact on quality of life and sexual relationships. Objective: To assess the efficacy and safety of a new type of non-ablative laser, Solid State Vaginal Laser (SSVL), for vaginal tissue regeneration and rejuvenation. Method: Eighty participants with GSM symptoms were treated with a total of 4 treatments in about two months (every 15 - 20 days) of a non-ablative SSVL (LASEmaR 1500TM-EUFOTON). A cumulative intensity of GSM symptoms using a 10-cm VAS (dryness and/or burning and/or dyspareunia), the vaginal health index (VHI), the Female Sexual Function Index (FSFI) were evaluated. Urinary Incontinence Short Form (ICIQ-UI SF) and vaginal bioptic samples were also collected. Results: Improvement following the SSVL was observed on VHIS, VVA symptoms and sexual female function. This finding was also ratified by the improvement of vaginal histological features. After the SSVL treatment, almost all patients (91%) affected by urinary incontinence obtained the complete remission of symptoms. Conclusion: The objective evaluation of VHIS, FSFI and ICIQ-UI SF scores and the histological results indicates a real favorable effect of SSVL on GSM and on urinary incontinence.