Image Institute, Milan, Italy.
Eur Rev Med Pharmacol Sci. 2018 Jan;22(2):567-574. doi: 10.26355/eurrev_201801_14211.
Urogenital atrophy is a degenerative process that may occur during menopause causing debilitating disorders and painful symptomatology. Estrogen therapy slows the onset of atrophy, but it requires ongoing therapy to maintain its effectiveness. To mitigate the degenerative evolutions associated with menopause, patients may benefit from new therapeutic approaches, such as the use of mesenchymal stem cells. Among the many sources, the adipose tissue is considered one of the smartest, due to its abundance and easy access. This study investigated the feasibility and potential benefits of using an autologous adipose tissue to treat the symptoms of urogenital atrophy.
In 2014, the first three women affected by post-menopausal urogenital atrophy were treated with injections of autologous and micro-fragmented adipose tissue (Lipogems®). Clinical outcomes were determined at 3, 6, 9, 12, 18, 24, and 36 months by evaluating vaginal dryness, burning, itching, stranguria, sensitivity, and dyspareunia. Pre- and 36 months post-op biopsies and vaginal discharge were also collected.
The three women reported a significant improvement of the symptoms at 6 months with complete resolution at 9 months. This benefit, subjectively reported and confirmed by clinical evaluation, remained constant without recurrence at least until 36 months. Immunohistochemical analysis revealed a total recovery of vaginal vitality with production of glycogen, vasculature hyperplasia and regeneration of the epithelium and subcutaneous tissue at 36 months. The analysis of vaginal discharge showed a restoration of an acid pH with the colonization of lactobacilli. No postoperative complications nor adverse events were recorded.
The results of these first three cases pointed to autologous and micro-fragmented adipose tissue as a safe, feasible and effective therapeutic approach for the treatment of post-menopausal urogenital atrophy.
泌尿生殖系统萎缩是一种退行性过程，可能发生在绝经期间，导致衰弱性疾病和疼痛症状。雌激素治疗可减缓萎缩的发生，但需要持续治疗以维持其疗效。为了减轻与绝经相关的退行性变化，患者可能受益于新的治疗方法，例如使用间充质干细胞。在许多来源中，脂肪组织因其丰富且易于获取而被认为是最聪明的来源之一。本研究调查了使用自体脂肪组织治疗泌尿生殖系统萎缩症状的可行性和潜在益处。
2014 年，首批 3 名受绝经后泌尿生殖系统萎缩影响的女性接受了自体和微碎片脂肪组织（Lipogems®）注射治疗。通过评估阴道干燥、灼热、瘙痒、排尿困难、敏感度和性交困难，在 3、6、9、12、18、24 和 36 个月时确定临床结果。还收集了术前和 36 个月的活检和阴道分泌物。
这 3 名女性在 6 个月时报告症状显著改善，9 个月时完全缓解。这种受益，主观报告并经临床评估证实，在至少 36 个月内保持不变，没有复发。免疫组织化学分析显示，阴道活力完全恢复，产生糖原，血管增生，上皮和皮下组织再生，36 个月时。阴道分泌物分析显示，随着乳杆菌定植，恢复了酸性 pH 值。未记录术后并发症或不良事件。
这前三例的结果表明，自体和微碎片脂肪组织是治疗绝经后泌尿生殖系统萎缩的一种安全、可行和有效的治疗方法。
