Morphological analysis of the structure of parafistulous tissues in patients with vesicovaginal fistulas by the local interstitial application of platelet-rich  plasma

Медведев, В. Л.; Opolskiy, A. M.; Горбань, Н. А.; Kogan, M. I.

doi:10.18565/urology.2021.1.21-26

Cited by 3 publications

(4 citation statements)

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“…In the literature, the only available VVF tissue immunohistological analysis was that which was undertaken by Medvedev et al [20]. Therein, they assessed the morphological structure of VVF tissues before and after PRP injection, and their histological examinations showed a reduction in inflammation process activity, a complete resolution of erosive and ulcerative lesions and a reduction of the fibrosis degree of the stromal layer in their PRP group.…”

Section: Discussionmentioning

confidence: 99%

Influence of Platelet-Rich Plasma on Recurrent Vesicovaginal Fistula—A Histological and Immunohistochemical Study

Streit-Ciećkiewicz,

Szumiło,

Grzybowska

et al. 2024

JCM

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Vesicovaginal fistula is a cause of deterioration in the quality of life. It is a communication between the bladder and vagina resulting in the uncontrollable leakage of urine through the vagina. Recently, regenerative methods have been used more frequently, and platelet-rich plasma is one of these methods. The functional properties of platelet-rich plasma are based on the synthesis and secretion of multiple growth factors released after platelet activation. The aim of this study was to investigate how platelet-rich plasma influences the condition of the tissue and the healing ability of the urothelium, vaginal epithelium and tissues surrounding the fistulous canal. The study included eight patients who had undergone the Latzko procedure aimed at closing the vesicovaginal fistula. Samples were collected during primary surgery without platelet-rich plasma and after failed surgery, during a second attempt. The specimens were subjected to histological and immunohistochemical evaluation. The histology demonstrated that in platelet-rich plasma patients, greater vascularization and wider subepithelial mucosa layering was observed. Inflammatory infiltration in the subepithelial layer was increased in platelet-rich plasma patients. No localization differences in growth factor proteins were found in either group, but in platelet-rich plasma-patients, the reactions were stronger. It can be concluded that the use of platelet-rich plasma improves the morphological structure of the injected tissues.

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Section: Discussionmentioning

confidence: 99%

Influence of Platelet-Rich Plasma on Recurrent Vesicovaginal Fistula—A Histological and Immunohistochemical Study

Streit-Ciećkiewicz,

Szumiło,

Grzybowska

et al. 2024

JCM

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“…Microcirculatory assessment may benefit the evaluation of innovative approaches for VVF repair, such as angiogenicinducing interventions. Multiple studies have evaluated the effect of platelet-rich plasma application in the surgical treatment of VVF [19][20][21]. Medvedev et al [19] assessed the neovascularization in the tissue surrounding VVFs after injection of platelet-rich plasma using biopsies to collect histological data on the microvascular density.…”

Section: Future Clinical Implicationsmentioning

confidence: 99%

“…Multiple studies have evaluated the effect of platelet-rich plasma application in the surgical treatment of VVF [19][20][21]. Medvedev et al [19] assessed the neovascularization in the tissue surrounding VVFs after injection of platelet-rich plasma using biopsies to collect histological data on the microvascular density. Using HVM, these data could be obtained non-invasively and longitudinally without the need for traumatic tissue sampling that could negatively affect tissue healing.…”

Section: Future Clinical Implicationsmentioning

confidence: 99%

The Microcirculation of Vaginal Tissue in Women with Obstetric Vesicovaginal Fistula and Short-Term Effects of Surgical Repair on Microvascular Parameters

Maljaars,

Kastelein,

Latul

et al. 2023

Gynecol Obstet Invest

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Objectives: To better understand the extent of the ischemic trauma and the effects of surgical repair on the vaginal microcirculation in patients with obstetric vesicovaginal fistula (VVF). Design: In this observational study, we evaluated the vaginal microvasculature surrounding VVF using handheld vital microscopy (HVM) before, during and two weeks after surgical VVF repair. Participants: Seventeen women undergoing VVF repair were included in this study. Setting: The study was conducted in the Fistula Care Centre in Lilongwe, Malawi. Methods: We used HVM with incident dark-field (IDF) imaging to non-invasively visualize the microvasculature of the vaginal tissue surrounding fistulas. The primary outcome was the presence of microvascular flow. Secondary outcomes included angioarchitecture, fistula closure (postoperative dye test) and urinary continence (pad weight test). Results: Microvascular flow was present before, during and after surgical repair in respectively 83.8%, 83.9% and 93.4% of obtained image sequences. The angioarchitecture was normal in 75.8% of the image sequences before surgery, 69.4% at fistula closure and 89.1% two weeks after VVF repair. Fourteen (82.4%) patients had a closed fistula after surgical repair. Limitations: The study was limited by the lack of a control group and the relatively small sample size. Conclusion: Although the vaginal microcirculation in women with VVF is compromised, extensive ischemic damage is not observed in the tissue surrounding fistulas. This suggests significant regenerative capacity of the vaginal vasculature in young women, or less extensive ischemic damage than presumed. Following surgical repair, we observed improvement of microcirculatory flow and angioarchitecture, suggesting that surgery is a good option for patients with obstetric VVF.

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“…Taking into account the statistically significant reduction in the activity of the inflammatory process, the complete healing of erosive and ulcerative lesions, and the decrease in the thickness of the fibrosis in the stromal layer of the fistula tissue, the application of PRP therapy in the surgical treatment of vesico vaginal fistulae should be considered appropriate and justifiable. 21 A vesico-vaginal fistula is an abnormal opening between the bladder and vagina, which is a stigmatized disease in many developing countries. Leakage of urine into internal organs can cause serious complications and delay wound repair.…”

Section: Regenerative Medicine and Wound Healingmentioning

confidence: 99%

The Role of Regenerative Medicine in Wound Healing in Cases of Vesicovaginal Fistulae

Kurniawati

Rahmawati

2021

J. Drug Delivery Ther.

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Background: Post-surgical wound healing in cases of vesicovaginal fistulae is a challenge because it is related to infection prevention and the long-term well-being of women. Aim: The aim of this research was to critically review the application of regenerative medicine in wound healing. The next aim was to look in depth to see whether regenerative medicine strategies have a place in the future of wound healing in a clinical setting. More specifically, to see if these strategies would apply for vesico vaginal fistulae case in the field of urogynecology. Method: A narrative literature review examines several previous research published at the last 5 years, containing keywords, namely vesicovaginal fistulae, regenerative medicine, wound healing. We used databases from Google Scholar, PubMed and Scopus Database. Results: A vesicovaginal fistula is an abnormal communication between the bladder and the vagina. There are currently no precise guidelines for the postoperative management of patients after fistula repair. Transvaginal surgical procedures are a common solution for vesicovaginal fistulas. In wound healing, more attention is needed because of the risk of infection especially wound healing in the area of the reproductive organs. It should also be noted that stress urinary incontinence is a common complication. Several studies have initiated the trial process of regenerative medicine for using in urogynecological cases. Conclusion: In the management of vesico vaginal fistula cases, regenerative medicine can be a solution in postoperative care but still needs further development and standardization. Keywords: placenta, urogynecology, regenerative medicine

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Morphological analysis of the structure of parafistulous tissues in patients with vesicovaginal fistulas by the local interstitial application of platelet-rich plasma

Cited by 3 publications

References 0 publications

Influence of Platelet-Rich Plasma on Recurrent Vesicovaginal Fistula—A Histological and Immunohistochemical Study

Influence of Platelet-Rich Plasma on Recurrent Vesicovaginal Fistula—A Histological and Immunohistochemical Study

The Microcirculation of Vaginal Tissue in Women with Obstetric Vesicovaginal Fistula and Short-Term Effects of Surgical Repair on Microvascular Parameters

The Role of Regenerative Medicine in Wound Healing in Cases of Vesicovaginal Fistulae

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