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 patientswere 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 andmucosae; 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 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 caseswhere the anatomical impairment does not allow a regular sexual function and a good quality of life.

Vulvar lichen sclerosus : a new regenerative approach through fat grafting / V. Boero, M. Brambilla, E. Sipio, C.A. Liverani, M. Di Martino, B. Agnoli, G. Libutti, F.M. Cribiù, A. Del Gobbo, E. Ragni, G. Bolis. - In: GYNECOLOGIC ONCOLOGY. - ISSN 0090-8258. - 139:3(2015 Dec), pp. 471-475. [10.1016/j.ygyno.2015.10.014]

Vulvar lichen sclerosus : a new regenerative approach through fat grafting

V. Boero;E. Sipio;C.A. Liverani;M. Di Martino;G. Libutti;A. Del Gobbo;E. Ragni;G. Bolis
2015-12

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 patientswere 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 andmucosae; 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 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 caseswhere the anatomical impairment does not allow a regular sexual function and a good quality of life.
Fat grafting; Lichen sclerosus; Stem cells; Vulva; Obstetrics and Gynecology; Oncology
Settore MED/40 - Ginecologia e Ostetricia
GYNECOLOGIC ONCOLOGY
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/358172
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