Comparative effects of fractional radiofrequency and microneedling on the genitalia of postmenopausal women: Histological and clinical changes

Rafaella Rêgo Maia; Ayane Cristine Sarmento; Rodrigo Marcel Valentim da Silva; Eneida de Morais Carreiro; Stephany Luanna Queiroga Farias; Ciro Dantas Soares; Patrícia Froes Meyer; Ana Katherine Gonçalves

doi:10.1016/j.clinsp.2022.100117

Comparative effects of fractional radiofrequency and microneedling on the genitalia of postmenopausal women: Histological and clinical changes

Clinics (Sao Paulo). 2022 Sep 29:77:100117. doi: 10.1016/j.clinsp.2022.100117. eCollection 2022.

Authors

Rafaella Rêgo Maia¹, Ayane Cristine Sarmento¹, Rodrigo Marcel Valentim da Silva², Eneida de Morais Carreiro³, Stephany Luanna Queiroga Farias⁴, Ciro Dantas Soares⁵, Patrícia Froes Meyer³, Ana Katherine Gonçalves⁶

Affiliations

¹ Health Sciences Postgraduate Program, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil.
² Physiotherapy Department, Centro Universitário do Rio Grande do Norte (UNI-RN), Natal, RN, Brazil; Physiotherapy Department, Universidade Estácio de Sá, Natal, RN, Brazil.
³ Physiotherapy Department, Centro Universitário do Rio Grande do Norte (UNI-RN), Natal, RN, Brazil.
⁴ Physiotherapy Department, Universidade Potiguar (UnP), Natal, RN, Brazil.
⁵ Tomatopathology Department, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
⁶ Health Sciences Postgraduate Program, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil; Department of obstetrics and gynaecology, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil. Electronic address: anakatherine_ufrnet@yahoo.com.br.

Abstract

Objectives: The authors aimed to evaluate clinical and histological changes induced by Fractional Radiofrequency (FRF) and microneedling in vulvar tissue.

Methods: Thirty postmenopausal women were randomly divided into G1 (FRF) and G2 (microneedling) groups. Sub-ablative FRF was executed using disposable fractionated electrodes with an intensity of 8 mJ. Microneedling was performed using a derma roller system. The authors evaluated before and after treatment using the Vaginal Laxity Questionnaire (VLQ), EuroQol Five-Dimensional (EQ-5D) questionnaire, and the Blatt and Kupperman Menopausal Index (BKMI). Additionally, the authors performed biopsies of the labia majora for histological analysis pre- and post-treatment. Data were expressed as mean (± standard deviation). A paired t-test was used for intra-group comparison (pre- and post-treatment), with an independent t-test used to compare intergroup data (both pre- and post-treatment).

Results: In the G1 group, the VLQ values showed differences compared to the pre-treatment values with the data obtained 60 days after the beginning of the sessions (p = 0.01). Similarly, the data changes of the G2 group proved to be significant (p = 0.001) across the same time interval. In comparing the groups, VLQ values were not different (p > 0.05). Regarding histological analysis, FRF demonstrated improvement concerning the number of fibroblasts, blood vessels, and fatty degeneration (p < 0.05) compared to the control. Additionally, FRF and microneedling samples showed higher type III collagen and vimentin expression in the immunohistochemical analysis (p < 0.05).

Conclusions: The therapies were found to be effective in treating the flaccidity of the female external genitalia. Additionally, histological changes were observed after interventions suggesting collagen remodeling.

Keywords: Flaccidity; Menopause; Microneedling; Radiofrequency.

Publication types

Randomized Controlled Trial

MeSH terms

Collagen Type III*
Female
Humans
Postmenopause*
Treatment Outcome
Vagina / pathology
Vimentin

Substances

Collagen Type III
Vimentin