Energy-Based Devices: Comparisons and indications

Abstract

Modern medicine offers a variety of treatment modalities aiming to manage a large diversity of gynecological conditions, varying from as little as topical gels or hormone-replacement therapy to invasive vaginal interventions. These feminine issues can affect women's daily lifestyle, quality of life or project physiological effects such as decreased self-confidence or impaired sexuality. Changes due to menopause, postpartum or other causes led to an emerging number of energy-based devices (EBD) for vaginal procedures that utilize ablative or thermal effects to sculpt the external vagina or to strengthen the aging vaginal wall. Available applications are mainly lasers yet other energy-based devices have also been introduced to regenerative gynecology and urogynecology, such as various types of RF (radiofrequency derives), High-intensity focused ultrasound (HIFU), Light-emitting diodes (LED) and high-intensity focused electromagnetic field (HIFEM). Karcher& Sadick [1] claim that the commonly used term of "vaginal rejuvenation" is in fact a generalized term for a wide array of gynecological esthetic and functional procedures that aim to restore the vagina and its surrounding tissues. According to their definition, the spectrum of procedures can range from mere vaginal atrophy (VA) and dryness, treated by minimally or noninvasive strategies, to cases that require invasive intervention such as labiaplasty or vaginoplasty. This chapter aims to introduce the main available technologies offering vaginal rejuvenation and restoration, its interaction with the tissue, and compare the technological differences.