Efeitos comparativos da radiofrequência fracionada e do microagulhamento na vulva de mulheres na pós-menopausa: alterações histológicas e clínicas

Abstract

The period of menopause brings different changes, such as vulvar flaccidity, which interferes with the female quality of life. Fractional radiofrequency and microneedling are non-invasive treatments that act on collagen fibers. The aim of this study was to evaluate the clinical and histological changes induced by Fractional Radiofrequency (RFF) and microneedling in vulvar tissue. Thirty postmenopausal women were randomly divided into groups G1 (RFF) and G2 (microneedling). Subablative RFF was performed with disposable fractional electrodes with an intensity of 8 mJ. Microneedling was performed with the derma roller system. Pre- and post-treatment times were evaluated using the Vaginal Laxity Questionnaire (VLQ), the EQ-5D questionnaire for quality of life, and the Blatt and Kupperman Menopause Index (BKMI). Biopsies of the labia majora were taken for histological and immunohistochemical analysis of the proposed treatments. Data were expressed as mean (± standard deviation). A paired t-test was used for intragroup comparison (pre- and post-treatment) and an independent t-test used to compare intergroup data (pre- and post-treatment). In the G1 group, the VLQ values showed differences from pre-treatment values with data obtained 60 days after the beginning of sessions (p=0.01). Likewise, the changes in the data from the G2 group were significant (p=0.001) in the same time interval. In the comparison between the groups, the VLQ values were not different (p>0.05). Regarding histological analysis, the RFF showed improvement regarding the number of fibroblasts, blood vessels and fatty degeneration (p<0.05) compared to the control. In addition, RFF and microneedling samples showed higher expression of type III collagen and vimentin in immunohistochemical analysis (p<0.05). The therapies proved to be effective in treating flaccidity of the female external genitalia. Furthermore, histological changes were observed after interventions suggesting collagen remodeling.