“…Frank described in 1938 the use of Pyrex tubes of gradually increasing sizes (0.8, 1.5 and 2.0 cm in diameter) to force the mucous membrane inward into the introital region (Frank, 1938;Lee, 2006). Interestingly, for almost 40 years this technique was only infrequently used, although his series and the majority of case reports suggested that this approach was one of promise (Holmes and Williams, 1940;Steinmetz, 1940;Campbell, 1941;Marshall, 1944;TeLinde, 1946;Williams, 1957). In 1981, Ingram modified the technique based on presumed inconveniences of Frank's method, such as sheer fatigue of the hands and fingers, the need to squat, and the inability to perform other productive activities during the procedure.…”
As the medical literature lacks high-quality comparative outcome studies and prospective, longitudinal studies are scarce, no evidence-based treatment guidelines can be provided. However, because of the physically low complication rate and an overall success chance of 75%, vaginal dilation as first choice treatment seems to be justified. Overall, the laparoscopic Vecchietti procedure, becoming more and more available in specialized centres, is considered an appropriate surgical option in patients who are poorly compliant and failed dilation therapy, or for those who do not want to start with vaginal dilation therapy. Future approaches need to raise a wider range of psychosexually oriented questions, elucidate the relationship between vaginal depth and satisfactory outcomes and gain additional experience concerning the format of acceptable and efficient psychological care.
“…Frank described in 1938 the use of Pyrex tubes of gradually increasing sizes (0.8, 1.5 and 2.0 cm in diameter) to force the mucous membrane inward into the introital region (Frank, 1938;Lee, 2006). Interestingly, for almost 40 years this technique was only infrequently used, although his series and the majority of case reports suggested that this approach was one of promise (Holmes and Williams, 1940;Steinmetz, 1940;Campbell, 1941;Marshall, 1944;TeLinde, 1946;Williams, 1957). In 1981, Ingram modified the technique based on presumed inconveniences of Frank's method, such as sheer fatigue of the hands and fingers, the need to squat, and the inability to perform other productive activities during the procedure.…”
As the medical literature lacks high-quality comparative outcome studies and prospective, longitudinal studies are scarce, no evidence-based treatment guidelines can be provided. However, because of the physically low complication rate and an overall success chance of 75%, vaginal dilation as first choice treatment seems to be justified. Overall, the laparoscopic Vecchietti procedure, becoming more and more available in specialized centres, is considered an appropriate surgical option in patients who are poorly compliant and failed dilation therapy, or for those who do not want to start with vaginal dilation therapy. Future approaches need to raise a wider range of psychosexually oriented questions, elucidate the relationship between vaginal depth and satisfactory outcomes and gain additional experience concerning the format of acceptable and efficient psychological care.
“…Non-surgical techniques are related with the least risk and rely on dilation of the existing dimple to create a neo-vagina. Currently, the first treatment approach is Frank’s technique where dilators of gradually increasing size are inserted for 10–30 min, 1–3 times a day by the patient ( Figure 4 B top) [ 104 ]. An adaptation of this method is Ingram’s technique which employs a bicycle seat to hold the dilators so the patient’s hands may be freed during treatment, using their own weight to exert pressure [ 105 ].…”
Section: Tissue Engineering In Gynecologymentioning
Female gynecological organ dysfunction can cause infertility and psychological distress, decreasing the quality of life of affected women. Incidence is constantly increasing due to growing rates of cancer and increase of childbearing age in the developed world. Current treatments are often unable to restore organ function, and occasionally are the cause of female infertility. Alternative treatment options are currently being developed in order to face the inadequacy of current practices. In this review, pathologies and current treatments of gynecological organs (ovaries, uterus, and vagina) are described. State-of-the-art of tissue engineering alternatives to common practices are evaluated with a focus on in vivo models. Tissue engineering is an ever-expanding field, integrating various domains of modern science to create sophisticated tissue substitutes in the hope of repairing or replacing dysfunctional organs using autologous cells. Its application to gynecology has the potential of restoring female fertility and sexual wellbeing.
“…Non-surgical techniques are related with the least risk and rely on dilation of the existing dimple to create a neo-vagina. Currently, the first treatment approach is Frank's technique where dilators of gradually increasing size are inserted for 10-30 minutes, 1-3 times a day by the patient (figure 4B top) [97]. An adaptation of this method is Ingram's technique which employs a bicycle seat to hold the dilators so the patient's hands may be freed during treatment, using their own weight to exert pressure [98].…”
Female gynecological organ dysfunction can cause infertility and psychological distress, decreasing quality of life of affected women. Incidence is constantly increasing due to growing rates of cancer and delaying of childbearing age in the developed world. Current treatments are often unable to restore organ function, and occasionally are the cause for female infertility. Alternative treatment options are currently being developed in order to face the inadequacy of current practices. In this review, pathologies and current treatments of gynecological organs (ovaries, uterus, and vagina) will be described. The state-of-the-art of tissue engineering alternatives to common practices are evaluated with a focus on in vivo models. Tissue engineering is an ever-expanding field, integrating various domains of modern science to create sophisticated tissue substitutes in the hopes of repairing or replacing dysfunctional organs using autologous cells. Application to gynecology has the potential of restoring female fertility and sexual wellbeing.
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