Efficacy and Safety of Platelet-Rich Plasma Injections for the Treatment of Female Sexual Dysfunction and Stress Urinary Incontinence: A Systematic Review

Introduction: There is no clear evidence in the literature that platelet-rich plasma (PRP) injections improve female sexual dysfunction (FSD) and female stress urinary incontinence (SUI). Objectives: A systematic review was performed to study the efficacy and safety of PRP injections in women with the above pathologies, as well as to explore the optimal dosing, frequency and area of injections, and duration of treatment. Methods: A systematic search on PubMed, Embase and the Cochrane Library database was performed, as well as sources of grey literature from the date of database or source creation to January 2023. After title/abstract and full-text screening, clinical studies on humans evaluating the efficacy of PRP in gynecological disorders using standardized tools were included. Risk of bias was undertaken with RoB-2 for randomized-controlled trials (RCT) and the Newcastle-Ottawa Scale (NOS) for observational studies. Results: Four prospective and one retrospective study explored FSD, while six prospective and one RCT evaluated female SUI. A total of 327 women with a mean age of 51 ± 12 years were included. For FSD, PRP significantly improved the Female Sexual Function Index (FSFI), the Vaginal Health Index (VHI) and the Female Sexual Distress score (FSDS). For SUI, PRP led to a significant improvement in the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) and the Urogenital Distress Inventory (UDI-6). The identified RCT reported a significantly higher mean score of ICIQ-SF (p < 0.05) and UDI-6 (p < 0.01) in the midurethral sling group compared to the PRP injections group. Regarding the risk of bias, the RCT was characterized by high risk, whereas the observational studies were of moderate risk. The protocol for PRP injections for FSD is the injection of 2 mL of PRP into the distal anterior vaginal wall once a month for 3 months. For female SUI, 5–6 mL of PRP should be injected into the periurethral area once a month for 3 months. Conclusions: Despite the promising initial results of PRP injections, the level of current evidence is low due to methodological issues in the available studies. It becomes clear that there is an emerging need for high-quality research examining PRP injections for the treatment of FSD and female SUI

Immunohistochemical studies on lymphocyte subpopulation in endometrium samples in women with infertility

Uterine leucocytes have been thought to play a key role in endometrial pathology and infertility.The aim of this study was to compare the amount of  CD20+, CD3+, CD56+, CD138+ cells in the endometrium from women with simple endometrial hyperplasia without atypia and thin endometrium with the presence of infertility. 95 patients, with simple endometrial hyperplasia without atypia, thin endometrium, and women without endometrial pathology (controls) were selected as research subjects. Hematoxylin and eosin staining were performed on all endometrial biopsies. Immunohistochemical staining for CD20+, CD3+, CD56+, CD138+  cells was applied to all tissue samples. Additionally, the disease histories of patients were collected, were held clinical and laboratory tests. The number of CD20+ cells was higher in 1 group (4,129±0,55) and 2 group (5,872±0,85), compared to fertile patients (1,353±0,16, p&lt;0.05). The ratio of CD3+ cells was higher in women with endometrial hyperplasia (108,871±14,34) and lower in women with a thin endometrium (36,388±3,83), compared to fertile patients (72,848±6,11, p&lt;0.05). The study shows a notable increase of CD138+ in specimens with hyperplasia (19,18±1,2) and thin endometrium (20,81±1.45) compared to fertile patients (1,02±0,5, p&lt;0.05 in both cases), and decreased of CD56-positive cells in stroma (43,4±2,2; 33.6±2.8) and in glands (7,4±1,2; 3.6±1,8) for hyperplasia and thin endometrium respectively compared to control group (51,2±2,5; 14,8±0,9). Women, with endometrial hyperplasia, have larger populations of CD20+, CD3+, and CD138+ and decreased amount of CD56+ in the stroma and glandular cells, as for women with thin endometrium, they have large populations of CD20+ and CD138+ and small of CD3+, CD56+, but bough groups may be at greater risk for infertility disorders resulting from an inflammatory environment occurring during implantation or later during decidualization.</p

Efficacy and Safety of Platelet-Rich Plasma Injections for the Treatment of Female Sexual Dysfunction and Stress Urinary Incontinence: A Systematic Review

Introduction: There is no clear evidence in the literature that platelet-rich plasma (PRP) injections improve female sexual dysfunction (FSD) and female stress urinary incontinence (SUI). Objectives: A systematic review was performed to study the efficacy and safety of PRP injections in women with the above pathologies, as well as to explore the optimal dosing, frequency and area of injections, and duration of treatment. Methods: A systematic search on PubMed, Embase and the Cochrane Library database was performed, as well as sources of grey literature from the date of database or source creation to January 2023. After title/abstract and full-text screening, clinical studies on humans evaluating the efficacy of PRP in gynecological disorders using standardized tools were included. Risk of bias was undertaken with RoB-2 for randomized-controlled trials (RCT) and the Newcastle-Ottawa Scale (NOS) for observational studies. Results: Four prospective and one retrospective study explored FSD, while six prospective and one RCT evaluated female SUI. A total of 327 women with a mean age of 51 ± 12 years were included. For FSD, PRP significantly improved the Female Sexual Function Index (FSFI), the Vaginal Health Index (VHI) and the Female Sexual Distress score (FSDS). For SUI, PRP led to a significant improvement in the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) and the Urogenital Distress Inventory (UDI-6). The identified RCT reported a significantly higher mean score of ICIQ-SF (p p Conclusions: Despite the promising initial results of PRP injections, the level of current evidence is low due to methodological issues in the available studies. It becomes clear that there is an emerging need for high-quality research examining PRP injections for the treatment of FSD and female SUI