RejuVAnate (Feminine Rejuvenation)

women-group

Vulvovaginal Atrophy (VVA), vaginal laxity after childbirth and bladder control issues are common conditions with great impact on quality of life.

RejuVAnate is a novel, minimally invasive pulsed CO2 laser treatment to vaginal tissues delivered through a special hand piece. Treatments have been shown to improve symptoms of:

  • VVA (painful intercourse, dryness, itching/irritation)
  • Vaginal laxity
  • Mild urinary incontinence or mild overactive bladder

A series of 3 pulsed CO2 laser treatments have been shown to stimulate the vaginal mucosa to increase collagen production, as well as causing a thickening of the vaginal epithelium, supporting the urinary structures as well as improving dryness and elastic stretch of the vaginal canal.

Improvement of worrisome vaginal and bladder symptoms after pulsed CO2 laser determines a better sexuality and quality of life, especially in women who are breast cancer survivors or otherwise not candidates for hormone therapy.

What is RejuVAnate?

A non-surgical, painless 15-minute office procedure utilizing CO2 fractional Laser technology delivered into the vagina via a hygienic, disposable vaginal-shaped probe. The procedure consists of 3 treatments (once every 4 weeks), with a “touchup” one year later. No downtime other than 3 days vaginal “rest” post-procedure. The results are a noticeable tightening of the entire vaginal canal for increased friction and pleasure during sexual intimacy. Specific treatment settings can be adjusted to help reverse the atrophic effects of aging in the vagina.

How does RejuVAnate improve vaginal tightening?

RejuVAnate works via pulses of laser energy into the collagen layer of the vaginal mucus membrane, where concentrated thermal heating leads to collagen and elastin “shrinkage” and secondary regeneration, producing a tightening of the vaginal tissues. The initial shrinkage and secondary regeneration produce improved pressure on the “G-Spot” and the clitoris. Tightening also occurs along the base of the overlying bladder, with evidence shows that it also improves the frustration of minor urinary incontinence.

The result of the treatment is the complete remodeling of the vaginal mucosa, in addition to the re-establishment of robust, more “youthful” vaginal tissue embedded with thick and long collagen fibers.

How does RejuVAnate improve vaginal atrophic changes?

By altering and rearranging collagen fibers, enabling the formation of elastin and better collagen formation, RejuVAnate can provide long-term reversal of the atrophic effects of aging on the vaginal walls.

How does RejuVAnate work?

A laser generator produces precise pulses which travel through a scanner where small, fractional beams of CO2 laser energy are delivered to vaginal tissues via a small tube-shaped hand piece.  These pulses exit through a small window in a 360º pattern allowing treatment of the entire vaginal canal, leading to overall tightening in the case of laxity, including tightening of the upper vagina, producing added support for the base of the bladder. In a different power setting, RejuVAnate may be utilized solely to stimulate collagen and elastin formation to enable a better elastic stretch of the vaginal tissues.

Who is a good candidate for this procedure? Who is not?

Candidates: Women with minimal to moderate vaginal looseness or laxity not severe enough to need a complete surgical repair (“Vaginoplasty”), but bothersome enough (less “grip,” too much “droop”) to diminish sexual pleasure and sometimes lead to modest urinary incontinence. Perfect candidates are:

  1. Women who have not yet had a child but either feel themselves “wide” inside or have a partner with a smaller-sized penis.
  2. Women with laxity after childbirth who plan on another child/children and need “temporary” tightening until their final childbirth, after which they may undergo a permanent surgical solution.
  3. Women with mild urinary incontinence.
  4. Women with only modest vaginal laxity and decent musculature, who wish to avoid a surgical procedure.
  5. Post-menopausal women with dry, atrophic vaginal tissues.

Not Candidates:

  1. Women with a significant pelvic floor vaginal laxity involving significant widening and muscular separation; these women need a surgical repair and will be disappointed with a solely laser procedure.
  2. Women with significant urinary incontinence and/or prolapse; these women need a surgical repair/“sling” or “tape” procedure.
  3. Women with very tightened, atrophic vaginas; these women will first need to undergo re-estrogenization and mild mechanical dilation in order to physically accommodate the treatment probe.

 

What is the science behind this procedure?

The RejuVAnate/Phoenix-15 laser utilizes CO2 fractional pulsed light wave technology as a cutting, tightening or resurfacing tool. In this instance, micro ablative laser waves at closely spaced intervals “drill” microscopic, closely spaced micro-punctures into the dermis, producing a mini-defect in the collagen that contracts, producing shrinkage and stimulating the collagen and elastin to grow, thus bulking and “rejuvenating” this layer. This technology has been utilized in vaginal procedures in Europe and Asia for more than 6 years, and a wealth of data has accumulated verifying its effects and success. 

Numerous observational studies reported a significant improvement of vaginal atrophy assessed subjectively and objectively after a cycle of three treatments of pulsed CO2 laser. Also sexual function and quality of life significantly improved. No complications or side-effects were reported during or after the laser procedure that was performed in an outpatient setting.

How long does RejuVAnate last?

Present data suggest that, with 3 treatments over a 12-week time period and especially with a “touchup” after one year, the tightening and continence effects are experienced for at least 2-3 years or more, while the atrophic elasticity effects are ongoing with no need for further treatments in properly managed patients.  Fractional CO2 treatments last around 4-5 years on the face and body.

Other nifty uses of this technology

Co2 Pixelated Laser technology may also be used to re-surface stretch marks and surgical scars. “Bleach” darkened peri-vaginal and peri-anal skin.

How much does it cost? Are there any discounts available?

The full price is $3,000 for the series of 3 treatments or $1200 per treatment if purchased individually.  For patients completing a 3 treatment series, a discounted price of $1,000 for the touch-up at one year intervals as needed.

Disclaimer:

Although satisfaction with fractional CO2 vaginal rejuvenation is over 90%, this is a relatively new technology. Although it has been cleared by the FDA, FDA approval of “medical devices,” unlike medications, is a short and not necessarily exhaustive process. While it appears, from a limited number of studies, that both laser tightening and relief from vaginal atrophy accomplishes what it promises with little risk of harm, there really are no well-controlled long-term (over 3-4 years) studies like there are for surgical procedures. Surgery remains the “gold standard” for vaginal tightening, but laser treatment may offer benefits in certain situations (see above.) Vaginal estrogen therapy remains the “gold standard” for vaginal health rehabilitation, but there are situations where laser treatment may offer advantages, especially in cases where estrogen therapy is contraindicated or not tolerated.

References:

“Emerging Trends in Nonsurgical Female Genital Rejuvenation” Vanaman, Bolton, Placik, Fabi, et al American Society for Dermatologic Surgery, Inc., 2016.

“Fractional CO2 laser for vulvovaginal atrophy (VVA) dyspareunia relief in breast cancer survivors” Pieralli, Fallani, Becorpi, Bianchi, Corioni, Longinotti, Tredici, Guaschino, et al. Arch Gynecol Obstet, 2016.

“The use of pulsed CO2 lasers for the treatment of vulvovaginal atrophy” Stefano, Salvatore, Stavros, Athanasiou, Massimo, Candiani, et al. Current Opinion in Obstetrics and Gynecology, Dec 2015.

“Novel Minimally Invasive VSP Er:YAG Laser Treatments in Gynecology.” Vizintin, Rivera, Fistonic, Sercaglu, Guimares, et al. Journal of the Laser and Health Academy, 2012.

“A 12-Week Treatment with Fractional CO2 Laser for Vulvovaginal Atrophy: A Pilot Study.” Salcatore, Nappi, Zerbinati, Calligaro, Ferrero, et al. Climateric, 2014

“Histological Study on the Effects of Microablative Fractional CO2 Laser on Atrophic Vaginal Tissue: An Ex Vivo Study.” Salvatore, Maggiore, Athanasiou, Origoni, Candiani, et al. Menopause, 2015

“Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90° and 360° Scanning Scopes: A Pilot Study & Short-term Results.” Lee. Laser Therapy, 2014

“Vulvo-Vaginal Atrophy: A New Treatment Modality Using Thermo-Abative Factional CO2 Lser.” Perino, Calligaro, Forlani, Tiberio, Cucinella, et al. Maturitas, 2015.