Pelvic floor disorders, including prolapse, incontinence, and vulvovaginal atrophy decrease the quality of life of every fourth woman. Recent therapy including habits change, rehabilitation, surgery, or hormonal replacement is not possible in all patients. Laser therapy is currently being proposed as an alternative. Laser therapy was brought to the gynecological field from dermatology, where it is used for facial rejuvenation (wrinkles) and treatment of other skin abnormalities. In dermatology, the laser has proven its efficacy at the molecular and histological levels. However, this concept was brought to gynecology without comparable confirmation. The skin and vagina have a different structures, therefore effects of laser may differ. Patient satisfaction with the clinical effects of laser has been reported. However, based on recent reviews and sheep studies knowledge about histological and other effects is limited. The goal of this study is to gain knowledge about the histological, biomechanical effects and molecular effects of laser on vagina. Control samples were collected from women undergoing colporrhaphy. The laser group underwent laser treatment prior to the surgery. The gained knowledge may improve laser protocols and in the future maybe laser therapy will become standard treatment in urogynecology.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
15
non-ablative vaginal laser application
Institute for the care of mother and child
Prague, Czechia
uniaxial biomechanical analysis
Young's modulus of elasticity at low and high deformations
Time frame: within month after completion of specimens
quantitative histological analysis - epithelial thickness
Hematoxylin-eosin - epithelial thickness (um)
Time frame: within 6 months after completion of specimens
quantitative immunohistochemistry -von Willebrand factor (vWF)
microvessels density (mm-2) The number of von Willebrand factor-positive microvessel profiles was divided by the sum of the areas of the counting frame and expressed as a two-dimensional density of microvessels (QA, quantity per area)
Time frame: within 6 months after completion of specimens
quantitative immunohistochemistry -orcein
elastin fibres - Area fraction ( %)
Time frame: within 6 months after completion of specimens
quantitative immunohistochemistry- picrosirius red
collagen I and III - Area fraction ( %)
Time frame: within 6 months after completion of specimens
molecular analysis - markers of inflammation
PCR (polymerase chain reaction) - TGFB (Transforming growth factor beta)
Time frame: within 6 months after results of histological analysis
molecular analysis - markers of inflammation
PCR - IL- 1 (Interleukin-1)
Time frame: within 6 months after results of histological analysis
molecular analysis - connective tissue remodeling
PCR - COLL1 (collagen type I)
Time frame: within 6 months after results of histological analysis
molecular analysis - connective tissue remodeling
PCR - MMP 1 (Matrix Metallopeptidase 1)
Time frame: within 6 months after results of histological analysis
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