Hyaluronic acid in vulvar and vaginal administration: evidence from a literature systematic review

Buzzaccarini, Giovanni; Marin, Loris; Noventa, Marco; Vitagliano, Amerigo; Riva, A.; Dessole, Francesco; Capobianco, Giampiero; Bordin, Luciana; Andrisani, Alessandra; Ambrosini, Guido

doi:10.1080/13697137.2021.1898580

Cited by 24 publications

(19 citation statements)

References 42 publications

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“…Change in pH is 1 of 3 FDA-recommended primary outcomes for treatment trials in GSM. A significant decrease in vaginal pH has been seen in trials of vaginal estrogen, vaginal DHEA, vaginal laser, hyaluronic acid, and vaginal gels containing lactic acid . Our findings demonstrate that a significant drop in pH with treatment does not necessarily reflect the same underlying biological effect in all cases.…”

Section: Discussionmentioning

confidence: 54%

“…A significant decrease in vaginal pH has been seen in trials of vaginal estrogen, 3,18 vaginal DHEA, 19 vaginal laser, 20 hyaluronic acid, and vaginal gels containing lactic acid. 2,21,22 Our findings demonstrate that a significant drop in pH with treatment does not necessarily reflect the same underlying biological effect in all cases. In premenopausal women, pH is often linked to levels of vaginal lactic acid.…”

Section: Discussionmentioning

confidence: 69%

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Impact of Topical Interventions on the Vaginal Microbiota and Metabolome in Postmenopausal Women

Srinivasan

Hua

et al. 2022

JAMA Netw Open

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Key Points Question What are the effects of estradiol or vaginal moisturizer on the vaginal microbiota, metabolome, and pH after 12-week treatment in postmenopausal women? Findings In this secondary analysis of 144 participants in a randomized clinical trial of postmenopausal women with moderate to severe vulvovaginal symptoms, women using vaginal 10 μg estradiol tablet demonstrated larger changes in the vaginal microbiota and metabolome compared with women using vaginal moisturizer or placebo, despite a decrease in pH within each intervention group. Meaning These findings suggest that treatment of genitourinary symptoms of menopause with topical estradiol changes the vaginal microenvironment in ways that may promote genitourinary health.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 69%

Impact of Topical Interventions on the Vaginal Microbiota and Metabolome in Postmenopausal Women

Srinivasan

Hua

et al. 2022

JAMA Netw Open

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“…In the very early stages, our goal is achieving a definitive oncological cure by surgery only reducing the recurrence risk to an absolute 0%. Although the emerging literature shows that there are therapeutic possibilities to preserve the quality of life and sexual discomfort during and after any adjuvant therapy [30,31,32], avoiding radiotherapy and chemotherapy by reducing recurrences of disease to 0% remains the main absolute goal.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Isolated lymph nodal recurrence after 10 years in FIGO Stage IA1 cervical adenocarcinoma treated with conization: case report and review of the literature

Arcieri¹,

Martinelli²,

Cianci³

et al. 2023

It Journ Gyn Obs

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Background. Cervical cancer (CC) represents the fourth most common cancer in women. Since about 25% of women with CC has 40 years or less, more and more women choose fertility-sparing surgery (FSS). FSS, such as conization, represents valid and safe procedures for patients with IA1 tumors without lymph-vascular involvement (LVSI); It has been established that, for this very early stage, the risk of node involvement is negligible (~ 1 %), that is why nodal staging can be skipped M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n 2 and definitive conization can be considered a curative treatment. The issue is that a wide consensus regarding the most appropriate follow-up protocols after FSS has not been achieved. Case presentation.It is reported a very unusual recurrence of cervical adenocarcinoma that is characterized by the site of metastasis that occurred at nodal level, instead of the most common recurrence site that is the cervix, and for the "time to recurrence" that was astonishing long because it occurred at 10 years after conization. Only English studies and those performed in humans were considered to compare the case study to the actual literature. 10 eligible studied were found.Conclusions. Undoubtedly, because of the rarity of the event, it is not possible to reach a clear conclusion. However, the analysis of this case report could be an opportunity to generate new hypothesis about natural history of the disease and to question the safety of FSS when applied outside the actual indications. It is of paramount importance to never lower our guard even on the very early stages, focusing on oncological secondary prevention. It reflects the importance of build a stricter follow up for these patients until new strong medical evidence will be showed.

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“…3), in the betweengroup analysis, no statistically significant difference was recorded before treatment administration between the prasterone and hyaluronic acid groups (median score, 12 [6][7][8][9][10][11][12] vs 11 [8][9][10][11][12]; P = 0.8). Conversely, a statistically significant difference was recorded after treatment administration between the two groups (median score, 8 [5][6][7][8][9][10][11] vs 10 [8-11]; P = 0.03).…”

Section: Secondary Endpoint I: Iciq-sf Questionnairementioning

confidence: 99%

Prasterone in the treatment of mild to moderate urge incontinence: an observational study

et al. 2022

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ObjectiveTo assess the effects of prasterone compared with hyaluronic acid on symptoms of mild to moderate urinary urgency in women with genitourinary syndrome of menopause.MethodsThis is an observational prospective cohort study. A total of 58 postmenopausal women were enrolled (from December 2019 to May 2021). Overactive Bladder Screener questionnaire, Patient Global Impression of Improvement questionnaire, International Consultation on Incontinence Questionnaire–Short Form, and International Quality of Life questionnaire were used.ResultsFifty-eight women, 29 (50%) and 29 (50%), were treated with prasterone and hyaluronic acid for 12 weeks, respectively. At the end of the study, 26 (89.7%) versus 3 (10.3%) women reported an improvement (Patient Global Impression of Improvement score ≤3) of the symptoms in the prasterone versus hyaluronic acid group. According to the International Consultation on Incontinence Questionnaire–Short Form, no statistically significant difference was recorded before treatment between the prasterone and hyaluronic acid groups (median, 12 [6-12] vs 11 [8-12]; P = 0.8). Conversely, a statistically significant difference was recorded after treatment between the two groups (median, 8 [5-11] vs 10 [8-11]; P = 0.03). According to the International Quality of Life, a statistically significantly lower median score was recorded in the prasterone compared with the hyaluronic acid group, before (73 [interquartile range {IQR}, 55-81] vs 89 [IQR, 67-94]; P < 0.01) and after (78 [IQR, 65-86] vs 87 [IQR, 72-99]; P = 0.04) treatment.ConclusionsThe current observational study supports the hypothesis that prasterone might improve the severity of urinary urge incontinence in this set of women. However, these results need to be confirmed in further studies with a controlled design and a larger population.

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Hyaluronic acid in vulvar and vaginal administration: evidence from a literature systematic review

Cited by 24 publications

References 42 publications

Impact of Topical Interventions on the Vaginal Microbiota and Metabolome in Postmenopausal Women

Impact of Topical Interventions on the Vaginal Microbiota and Metabolome in Postmenopausal Women

Isolated lymph nodal recurrence after 10 years in FIGO Stage IA1 cervical adenocarcinoma treated with conization: case report and review of the literature

Prasterone in the treatment of mild to moderate urge incontinence: an observational study

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