Système reproducteur et troubles sexuels : recherche actuelle
Libre accès
ISSN: 2161-038X
ISSN: 2161-038X
Najwa Alfarra
Abstrait
Contexte et objectifs : L'incontinence urinaire et la dysfonction sexuelle sont extrêmement courantes chez les femmes. Elles entraînent un problème social ou stérile. L'incontinence urinaire est l'écoulement incontrôlé d'urine. Cette affection touche environ 33 % de la population féminine et est plus fréquente chez les femmes que chez les hommes5. Récemment, le laser Action II Petite Lady s'est distingué dans le traitement de l'incontinence urinaire et des troubles sexuels en tant que moyen non intrusif conçu pour stimuler la qualité de vie d'une femme en redressant son canal vaginal. L'étude actuelle a évalué l'efficacité clinique du laser Action II Petite Woman dans le traitement des troubles sexuels et de l'incontinence urinaire chez les femmes.
Sujets et méthodes : Trente femmes souffrant d'incontinence urinaire et de dysfonction sexuelle, âgées de 25 à plusieurs années ont été traitées pendant quatre séances de quatorze jours espacées entre les trois premières séances et d'un mois espacé entre la troisième et la quatrième séance avec un Er:YAG de 2940 nm à 90° et 360 degrés de filtrage. Les évaluations PFX2 ont été réalisées au point de référence, un mois après le traitement et deux mois après le traitement pour la force musculaire vaginale. Des enquêtes FSFI ont été réalisées avant et après la médiation, et des journaux de la vessie ont été utilisés. La satisfaction abstraite a été évaluée sur la satisfaction sexuelle.
Résultats : Tous les sujets ont terminé l'étude avec succès sans aucun événement indésirable. Une amélioration notable de la force musculaire vaginale a été constatée chez tous les sujets à 2 mois post-traitement en fonction des valeurs PFX2, la satisfaction sexuelle telle qu'évaluée par les sujets eux-mêmes était de 57,7 % satisfaite et de 42,3 % satisfaite. L'examen entre les méthodes pour les limites considérées lors du traitement a indiqué une différence significative dans la réduction des manifestations de l'incontinence d'effort.
Conclusions : Le traitement au laser Er:YAG pour l'incontinence urinaire et les troubles sexuels a apporté une amélioration notable. Avec la multidiffusion transmise dans les différents modes de battement à petite échelle au moyen d'extensions de balayage à 90 et 360°, le traitement au laser Er:YAG non chirurgical était sans douleur, sûr, sans symptôme, facilement supporté et efficace.
Introduction: Vaginal relaxation Syndrome (VRS) is characterized as laxity of the vaginal wall. It can bring about loss of rubbing and sexual fulfillment for both a ladies and her accomplice, regularly alluded to as "free vagina". Urinary incontinence is another issue related to VRS, both of the pressure or urge type, and can be somewhat aggravating or absolutely crippling. Various sorts of VRS treatment alternatives exist from noninvasive ways to deal with intrusive surgeries. For the noninvasive methodologies, social strategies (bladder preparing, booked latrine preparing, pelvic floor activities can straighten out loosened up musculature in the pelvic floor, electrical incitement, and biofeedback). In any case, despite the fact that these are noninvasive
choices, the adequacy is fairly restricted and the inertness time frames transitory, requiring constant development. Surgeries are progressively obtrusive and have a higher danger of complexities, for example, down an ideal opportunity for recouping, dangers related to the scar arrangement, or nerve harm than noninvasive treatments, yet it can likewise give a drawn-out arrangement in extreme cases. The laser has as of late been added to the treatment of VRS as a protected strategy of a treatment since it is entry pointless and practically easy with no cutting draining or heights. Recuperation is incredibly speedy without the requirement for the utilization of analgesics or anti-microbials. Studies affirmed that Er: YAG (2940nm) is a viable protected and agreeable treatment alternative for side effects alleviation in persistent with urinary incontinence since it limits harm profundity with specific frequencies having high water retention.
Identification and description of the investigational device: The Action II is a strong state Er: YAG laser discharging laser vitality at the frequency of a 2940 nm at which water is the primary chromospheres, with this frequency having the most noteworthy retention rate in the water among the typical lasers utilized in a medical procedure and medication. Given the high water substance of skin and delicate tissue, this makes the Action II framework perfect for any sign requiring removal or vaporization of skin. The Er: YAG laser can expel skin nearly cell layer by cell layer with 5-20 um accuracy. What's more, since its retention rate in water limits infiltration of the Er: YAG laser bar into the tissue, the warm harm in the objective tissue is constrained to a couple um. Therefore, the post-treatment fix process is a lot quicker after ER: YAG removal and the likelihood of entanglements (erythematic, pigmentation) is low. Exact Er: YAG laser removal can give incredible feathering between the rewarded and untreated tissue, can exactly shave territories of hyperplasic skin, and help with atrophic zones advancing the blend of collagen in the regions around focused skin.
Methods: In this prospective study, a single-focus study, 30 patients experiencing pressure urinary incontinence and sexual brokenness experienced treatment with a 2940 nm Er: YAG Laser (Action II unimposing woman). An examination was endorsed by the morals advisory group of King Faisal Specialist Hospital and Research Center, Saudi Arabia.
Treatment procedure: The anterior vaginal divider was treated by Er: YAG laser (2940nm) (Action II modest woman). Preceding the laser treatment the patient's vaginal channel was completely washed and the sterilizing arrangement deliberately got dry and expelled from the mucosa. Next, a uniquely structured laser speculum was acquainted into the patient's vagina with fill in as a guide for the laser shaft conveyance framework. Er: YAG90 scope utilized as various miniaturized scale beat mode, three multishot setting, beat width of 250, and 1.7 J/shot. The three passes were conveyed along the whole length of the vaginal waterway in every treatment meeting. For each arrangement of the shots the dynamic piece of the degree was set at the 12 O'clock the laser is discharged and the extension is pulled back by 2 graduation 5mm the procedure is rehashed, at that point rehash a similar procedure at 2 O'clock, 4 O'clock, 6 O'clock, 8 O'clock, and 10 O'clock, these positions were chosen to treat the whole circuit of the vaginal divider. In meeting 3 and 4 an extra 2 passes/meeting were conveyed with 360 degrees in since quite a while ago beat mode beat width of 1000ms (1S), 3.7 J/Shot. Convention called for four treatment meetings fourteen days separated between the initial three meetings and one month separated between the third and fourth sessions.
Results: A sum of 30 patients with stress incontinence and sexual brokenness were enrolled. Every one of the 30 patients experienced the Er: YAG laser treatment. Prior to the treatment, FSFI and the PFX2and bladder journal were performed. At the 1-month development, the PFX2and bladder journal was performed with each of the 30 patients. A sum of 30 patients experienced a 10 weeks development. The normal treatment time was 25 minutes. The impression of agony and uneasiness was checked during the treatment. Not exactly 50% of the patients evaluated the Er: YAG laser treatment as absolutely effortless, while the others announced exceptionally mellow agony or consuming sensation during the treatment. Patients came back to their normal exercises following treatment, and no unfriendly impacts were accounted for. Patients were just mentioned to limit from sexual activities for a time of 48 hours after every one of the treatment sessions.
Conclusion : L'étude prospective sur l'effet du traitement par laser Er:YAG chez la femme enceinte a démontré une efficacité remarquable dans l'amélioration de l'étanchéité vaginale avec une détresse minime de la patiente pendant les séances de traitement et aucun effet secondaire. D'autres études sont en cours de préparation, qui comprendraient l'utilisation d'outils d'évaluation supplémentaires comme un périnéomètre et des sondes plus approuvées. De plus, une période plus longue de séances ultérieures pouvant aller jusqu'à 30 mois est prévue.
Ce travail est en partie présenté lors de la 8e Conférence mondiale sur la santé des femmes et le cancer du sein, qui se tiendra du 17 au 18 décembre 2018 à Abu Dhabi, aux Émirats arabes unis.