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

Abstract Background PRP derived exosome has been used for a very long time in genital area rejuvenation applications. Objectives The aim of this study is to investigate the effect of the newly defined genital PRP derived exosome injection point compared to conventional genital injection points. Methods PRP derived exosome was taken into two one cc syringes. 4 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 part of the clitoral glans at 3-9 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 to 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 FSFI scale before the 1st session and 6 and 12 months after the 3rd session. Results The difference between the FSFI increase levels in two different periods for each group was evaluated. Accordingly, the FSFI increase in Group A was similar to the increase in Group D (p=0.715). The FSFI increase in Group B was similar to the increase in Group C (p=0.437). 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=0.001; Group A vs Group C, p=0.015; Group D vs Group B, p=0.027; Group D vs Group C, p=0.018). Conclusions Our 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 due to its easy applicability, low cost and low side effect rate.