Fat Grafting in Vulvar Lichen Sclerosus: Long Term Follow-Up

被引:3
|
作者
Boero, Veronica [1 ]
Brambilla, Massimiliano [2 ]
Di Loreto, Eugenia [1 ]
Cetera, Giulia Emily [1 ,5 ]
Cipriani, Sonia [3 ]
Boggio, Francesca [4 ]
Monti, Ermelinda [1 ]
Libutti, Giada [1 ]
Caia, Carlotta [1 ]
Parazzini, Fabio [1 ,3 ]
机构
[1] Fdn IRCCS CaGranda, Osped Maggiore Policlin Milano, Gynecol Unit, Milan, Italy
[2] Fdn IRCCS CaGranda, Osped Maggiore Policlin Milano, Plast Surg Serv, Milan, Italy
[3] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy
[4] Fdn IRCCS CaGranda, Osped Maggiore Policlin Milano, Dept Pathol, Milan, Italy
[5] Fdn IRCCS CaGranda Osped Maggiore Policlin, Gynecol Unit, Via Commenda 12, I-20122 Milan, Italy
关键词
fat grafting; vulvar lichen sclerosus; regenerative medicine; FIBROSIS; TISSUE;
D O I
10.1097/LGT.0000000000000766
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: The rationale for the use of autologous fat grafting in the treatment of vulvar lichen sclerosus (VLS) consists in reduction of inflammation, regeneration of tissues, volume increase, and pain fiber control. The main outcome of this study was the evaluation of patients' satisfaction after treatment. Secondary outcomes included modifications in symptoms, psychosexual wellbeing, vulvar hydration, and histology after surgery.Methods: Eligible for this study were women aged 18-85 years with a histological diagnosis of VLS who underwent at least one autologous vulvar fat grafting at the authors' center, between 2010 and 2019. In 2021, all women underwent a clinical reevaluation, comprehensive of vulvoscopy, vulvar biopsy, and handing out of validated questionnaires.Results: Overall, 88.7% of patients declared themselves very satisfied/satisfied with the procedure. All symptoms were improved postsurgery; in particular, the difference was statistically significant for pruritus, burning, and dyspareunia (p < .05). Sexual function was also improved at time of reevaluation, as were depressive and anxiety symptoms (p < .05). No cases of vulvar intraepithelial neoplasia or cancer occurred during follow-up and vulvar architecture remained stable, although patients reported a significantly reduced need for topical steroids (p < .0001). Lastly, in postoperative biopsies, inflammatory infiltrate was stable or reduced, and the distribution of elastic fibers was comparable or restored in most patients.Conclusions: Patient satisfaction with fat grafting is detectable up to 11 years after surgery, and as such, it may represent a valid therapeutic option in selected cases of VLS.
引用
收藏
页码:365 / 372
页数:8
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