Department of Anatomy, School of Basic Medicine Sciences, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, China.
Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, 510010, China.
Aesthetic Plast Surg. 2021 Jun;45(3):1231-1241. doi: 10.1007/s00266-020-02054-w. Epub 2021 Mar 1.
Vaginal atrophy caused by the aging process and perineal trauma has a negative impact on women. A new vaginal atrophy treatment is injection of materials into the vaginal wall, including platelet-rich plasma (PRP), autogenous fat graft (AFG), hyaluronic acid (HA), botulinum toxin (BTX), and collagen, but to date their efficacy has not been reviewed. Vaginal wall injection is available only for mild cases of vaginal atrophy or as an adjunct to vaginal surgery. PRP is used mainly to restore vaginal function, and multiple injections are needed to achieve good results in vaginal atrophy. HA, AFG, and collagen are used mainly to augment the vaginal wall. BTX injection can inhibit vaginal muscle spasm and reduce pain during sexual intercourse in patients with vaginismus. Injection of most of these materials into vaginal wall is effective and relatively safe. Vascular embolisms are the most serious complication of vaginal injection and should be prevented. In addition, there has been no randomized double-blind placebo-controlled trial or discussion of methods to avoid serious complications resulting from vaginal injection. Therefore, further studies of the injection of materials into the vaginal wall to treat vaginal atrophy are required, and the procedures should be standardized to benefit more patients.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
由于衰老过程和会阴部创伤导致的阴道萎缩会对女性造成负面影响。一种新的阴道萎缩治疗方法是向阴道壁注射材料，包括富血小板血浆（PRP）、自体脂肪移植（AFG）、透明质酸（HA）、肉毒杆菌毒素（BTX）和胶原蛋白，但迄今为止，其疗效尚未得到评估。阴道壁注射仅适用于阴道萎缩的轻度病例，或作为阴道手术的辅助手段。PRP 主要用于恢复阴道功能，需要多次注射才能在阴道萎缩中取得良好效果。HA、AFG 和胶原蛋白主要用于增加阴道壁。BTX 注射可抑制阴道肌肉痉挛，并减轻阴道痉挛患者性交时的疼痛。这些材料中的大多数注入阴道壁都是有效且相对安全的。阴道注射最严重的并发症是血管栓塞，应予以预防。此外，对于阴道注射导致严重并发症的方法，尚无随机双盲安慰剂对照试验或讨论。因此，需要进一步研究向阴道壁注射材料治疗阴道萎缩的方法，并标准化该程序，以使更多患者受益。证据等级 IV 本期刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266 。
