Human Trial for the Effect of Plasma-Activated Water Spray on Vaginal Cleaning in Patients with Bacterial Vaginosis

Abstract

Underwater plasma discharge temporally produces several reactive radicals and/or free chlorine molecules in water, which is responsible for antimicrobial activity. Hence, it can simply sanitize tap water without disinfectant treatment. Additionally, the spraying technique using cleaning water exploits deep application in the narrow and curved vaginal tract of patients. Herein, we attempted a clinical trial to evaluate the vaginal cleaning effect of spraying plasma-activated water (PAW) to patients with vaginitis (46 patients). The efficacy was compared with treatment with betadine antiseptics used to treat bacterial vaginosis (40 patients). To evaluate the cleaning effect, Gram staining of the vaginal secretions was conducted before and after spraying PAW or betadine treatment (BT). Consequently, PAW-sprayed (PAWS) patients (22.3%) showed a better vaginal cleaning effect against Gram-positive and -negative bacteria than BT patients (14.4%). Moreover, 18 patients in the BT group showed worsened vaginal contamination, whereas five patients in the PAWS group showed worsened vaginal contamination. Taken together, the noncontact method of spraying cleaning water to the vagina exhibited a reliable vaginal cleaning effect without further bacterial infection compared with BT. Therefore, we suggest a clinical application of the spraying method using PAW for vaginal cleaning to patients with vaginitis without disinfectants and antibiotics.

Analyses of the Chemical Composition of Plasma-Activated Water and Its Potential Applications for Vaginal Health

“…In previous studies, we confirmed the bactericidal effect of PAWs on clinically abnormal vaginal microbiota in clinical practice [14,19,20]. Patients sprayed with PAW (22.3%) had fewer Gram-positive and -negative bacteria than betadine treatment (BT) patients (14.4%) [14]. A significant decrease after treatment was observed in the following pathogenic organisms: Mycoplasma hominis (30 ± 15.28% decrease), Ureaplasma urealyticum (25 ± 9.93% decrease), Ureaplasma parvum (23 ± 8.42% decrease), and Candida albicans (28 ± 10.86% decrease) [19].…”

“…In previous studies, we confirmed the bactericidal effect of PAWs on clinically abnormal vaginal microbiota in clinical practice [14,19,20]. Patients sprayed with PAW (22.3%) had fewer Gram-positive and -negative bacteria than betadine treatment (BT) patients (14.4%) [14].…”

“…Our innovative vaginal cleaning device employing underwater plasma discharge generates various reactive radicals in tap water, conferring it with antibacterial activity [14,19,20]. The effectiveness of PAW in terms of antibacterial activity is contingent on its chemical composition.…”

“…Lee and Hong demonstrated that plasma discharge in tap water helps eliminate harmful microorganisms by increasing the concentrations of free residual chlorine molecules such as hypochlorous acid and hypochlorite ions [14][15][16]. While the exact mechanisms remain unclear, PAW has been shown to have antibacterial and cytotoxic activity, which has been attributed to the reactive species present in PAW [4,5,17,18].…”