title: Laxity of the vaginal introitus after childbirth: nonsurgical outpatient procedure for vaginal tissue restoration and improved sexual satisfaction using low-energy radiofrequency thermal therapy.
abstract: BACKGROUND
  Vaginal childbirth may result in vaginal introital laxity, altered genital sensation during sexual intercourse, and reduced sexual satisfaction. We report the long-term effectiveness of a single nonsurgical procedure with radiofrequency (RF) energy for laxity at the vaginal introitus.
  
  
  METHODS
  Prospective single-arm study of 30 premenopausal women (21-52 year) with one 30-minute office procedure using RF applied to the vaginal introitus; 12-month outcome assessments included the linguistic validated Japanese versions of the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R) and the Vaginal Laxity and Sexual Satisfaction Questionnaires.
  
  
  RESULTS
  Sexual function improved significantly throughout 6 months (30 subjects); mean FSFI total score was 22.4±6.7 before treatment and then improved to mean 26.0±5.8 at month 6 (P=0.002), inclusive of improved scores in five of six FSFI domains except desire (P<0.001 -<0.01). In the 22 of 30 subjects remaining evaluable at 12 months, the mean was 26.0±5.2 (P=0.08). Distress related to sexual activity decreased significantly; baseline FSDS-R mean score of 15.8±11.7 improved to 9.8±8.0 at one month and was sustained throughout 12 months (P<0.001 - 0.002). Subjects reported decreased vaginal laxity within the first month after the procedure (P<0.001); responses peaked, and effectiveness was sustained through 12 months (P<0.001).
  
  
  CONCLUSIONS
  A single nonsurgical office-based RF procedure for vaginal introital laxity achieved significant and sustainable 12-month effectiveness with respect to improved integrity at the vaginal introitus and improved sexual satisfaction. Treatment was well-tolerated with no adverse events.
authors: Yokohama Motomachi Women's Clinic LUNA, Yokohoma, Japan. mkrychman@aol.com
authors: Yuki
authors: Y
authors: Sekiguchi
authors: Yukari
authors: Y
authors: Utsugisawa
authors: Yoko
authors: Y
authors: Azekosi
authors: Manami
authors: M
authors: Kinjo
authors: Mihyon
authors: M
authors: Song
authors: Yodhinobu
authors: Y
authors: Kubota
authors: Sheryl A
authors: SA
authors: Kingsberg
authors: Michael L
authors: ML
authors: Krychman
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004548:Elasticity / Q000502:physiology / Q000528:radiation effects*; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D010045:Outpatients; D010549:Personal Satisfaction; D017697:Premenopause; D011446:Prospective Studies; D000078702:Radiofrequency Therapy; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology / Q000628:therapy*; D020018:Sexual Dysfunctions, Psychological; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014621:Vagina / Q000503:physiopathology*