Vulvar lichen sclerosus: A new regenerative approach through fat grafting
Abstract Objective The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulva...
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| Published in: | Gynecologic oncology Vol. 139; no. 3; pp. 471 - 475 |
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01-12-2015
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| Abstract | Abstract Objective The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. Methods Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80 years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. Results 34 out of 36 patients (94%) showed a better vulvar trophism of the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia majora and minora, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p < 0001) and FSFI (p < 0001). Conclusions Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life. |
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| AbstractList | OBJECTIVE. The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. METHODS. Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80 years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. RESULTS. 34 out of 36 patients (94%) showed a better vulvar trophismof the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia major a and minor a, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p b 0001) and FSFI (p b 0001). CONCLUSIONS. Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life. Abstract Objective The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. Methods Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80 years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. Results 34 out of 36 patients (94%) showed a better vulvar trophism of the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia majora and minora, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p < 0001) and FSFI (p < 0001). Conclusions Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life. The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. 34 out of 36 patients (94%) showed a better vulvar trophism of the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia majora and minora, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p<0001) and FSFI (p<0001). Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life. •Lichen Sclerosus (LS) often leads to anatomical impairment prejudicing life quality.•Vulvar Fat Graft is a completion therapy of LS, thanks to its regenerative power.•Fat Grafting in Vulvar LS can improve anatomical impairments and sexual activity |
| Author | Liverani, Carlo A Libutti, Giada Bolis, Giorgio Del Gobbo, Alessandro Agnoli, Benedetta Brambilla, Massimiliano Sipio, Elisa Di Martino, Mirella Ragni, Enrico Boero, Veronica Cribiù, F.M |
| Author_xml | – sequence: 1 fullname: Boero, Veronica – sequence: 2 fullname: Brambilla, Massimiliano – sequence: 3 fullname: Sipio, Elisa – sequence: 4 fullname: Liverani, Carlo A – sequence: 5 fullname: Di Martino, Mirella – sequence: 6 fullname: Agnoli, Benedetta – sequence: 7 fullname: Libutti, Giada – sequence: 8 fullname: Cribiù, F.M – sequence: 9 fullname: Del Gobbo, Alessandro – sequence: 10 fullname: Ragni, Enrico – sequence: 11 fullname: Bolis, Giorgio |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26499935$$D View this record in MEDLINE/PubMed |
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| Snippet | Abstract Objective The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary... The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess... OBJECTIVE. The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was... |
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| SubjectTerms | Adipose Tissue - transplantation Adult Aged Aged, 80 and over Clitoris - physiology Elasticity - physiology Fat grafting Female Hematology, Oncology and Palliative Medicine Humans Lichen sclerosus Middle Aged Mucous Membrane - pathology Mucous Membrane - physiology Obstetrics and Gynecology Quality of Life Regeneration Sexuality Skin - pathology Skin Physiological Phenomena Stem cells Vulva Vulva - physiology Vulvar Lichen Sclerosus - pathology Vulvar Lichen Sclerosus - physiopathology Vulvar Lichen Sclerosus - surgery |
| Title | Vulvar lichen sclerosus: A new regenerative approach through fat grafting |
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