Platelet-Derived Exosome Vulvar Injections for Sexual Dysfunction: A Retrospective Review

Abstract Background Platelet-rich plasma (PRP)-derived exosomes have been used for a very long time in genital area rejuvenation applications. Objectives The authors of this study aim to investigate the effect of the newly defined genital PRP-derived exosome injection point compared with conventional genital injection points. Methods PRP-derived exosomes were taken into two 1 cc syringes. Four injection areas were determined. Only 1 area was injected in each group. In Group A, a total of 2 cc of exosome was injected into the right and left lateral parts of the clitoral glans at 3 to 9 o'clock with a 32 G 4 mm syringe tip. The procedure was applied so that the entire 4 mm syringe tip entered the tissue. In Group B, a total of 2 cc of exosome was injected into the G-spot area around the distal third of the anterior wall with a point-by-point technique with a 32 G 4 mm syringe tip. In Group C, exosome injection was performed with a 32 G 4 mm syringe tip, 1 cc on the right side, 1 cc on the left side, and 2 cc in total, to the periurethral area. In Group D, exosome injection was performed at the junction point of frenulum, prepuce, and labium minus and its surroundings: 1 cc on the right side, 1 cc on the left side, and 2 cc in total. This procedure was performed in 3 sessions, 4 weeks apart. All patients were evaluated with the Female Sexual Function Index (FSFI) scale before the first session and 6 and 12 months after the third session. Results The difference between the FSFI increase levels in 2 different periods for each group was evaluated. Accordingly, the FSFI increase in Group A was similar to the increase in Group D (P = .715). The FSFI increase in Group B was similar to the increase in Group C (P = .437). The FSFI increase in Groups A and D was statistically greater than the increase in Groups B and C (Group A vs Group B, P = .001; Group A vs Group C, P = .015; Group D vs Group B, P = .027; Group D vs Group C, P = .018). Conclusions This study is the first example in the literature in terms of evaluating the difference between the points where PRP-derived exosomes were applied. This new point injection increased FSFI better than Group A and was as effective as Groups B and C. The effectiveness of this newly defined method has been investigated with a single-point injection point, and it is seen that the frequency of application will increase because of its easy applicability, low cost and low side effect rate. Level of Evidence: 4 (Therapeutic)