PRP in Gynecology practice

Platelets is part of the cell in our blood that help in the clotting mechanisms. It’s a very tiny cells but inside the contain a lot of important growth factors such as:-
  • Platelet Derived Growth Factors (PDGF)
  • Vascular Endothelial Growth Factors (VEGF)
  • Insulin Like Growth Factors ( IGF 1& 2)
  • Transforming Growth Factors beta( TGF-b)
  • Fibroblast Growth Factors ( FGF)
  • Epidermal Growth Factors ( EGF )
  • Connective Tissue Growth Factors (CTGF)
  • Interleukin 8 (IL 8)

All these growth factors are very important for healing, formation of new vessels, collagen production and regeneration!

What is Platelet Rich Plasma (PRP)?
It’s a autologous ( means patient’s own blood) concentration of platelets in a small volume of plasma usually 5 to 10 fold the normal level of the whole blood.

Since the platelets is so concentrated, so do all the growth factors also will be 5 to 10 folds higher.

How to PRP is prepared?
PRP preparation is usually done in the clinic as an outpatient procedure. There is no need for admission or general anaesthesia.
The doctor will collect usually 20 to 50ml of blood from you. The blood is then send for centrifuge to separate the platelet from the unwanted red blood cells and plasma. The layer that contains the concentrated platelets is then harvested and ready to be use.
Is PRP safe?
Since it’s an autologous preparation, there is no risk of any transmissible infection such as HIV or Hepatitis B. It’s never disturb the DNA of the cells, hence there is no risk at all on stimulation of cancer formation!

What is the potential usage of PRP in Gynecology?

PRP was first used back in 1987 for musculoskeletal injuries. It’s a very effective treatment especially for sports injuries and well documented.

The usage in Gynecological conditions has been picking up in the recent years. In United State alone in 2009, it was reported about 100000 cases of  usage of PRP in Obstetrics and Gynecology.

PRP usage has been reported in Gynecology in the following conditions:-
  1. Wound Healing: It has been proven that usage of PRP will accelerate the healing of any surgical wound and reduce the duration of hospital stay even in high risk patient such as patient with Diabetes Mellitus . The need for painkillers is also reduced.
  2. Vulvar lesions/ Cervical ectopy: PRP has been tried in many dermatological and autoimmune conditions of the vulvar such as Lichen Sclerosis which causes severe pruritus, dyspareunia and bleeding problems.  Nearly all patients who are treated with PRP show improvement. PRP has also been shown to be as effective as laser in treating patients with cervical ectopy with less complications such as infection or bleeding.
  3. PRP in genital prolapse and genital fistula: Study has found that in patients with small genital fistula, conservative therapy with PRP injection has been very successful. The ability of PRP in restoring the anatomy and function of the pelvic ligaments also helpful in women with genital prolapse especially in the early stage.
  4. PRP in reproductive medicine: There is promising results in women with premature ovarian failure treated with PRP injection into the ovaries under ultrasound guidance. However this modality if treatment is still under clinical trials and not a routine treatment. Study also has been very promising that injection of PRP into the endometrium may help improving the implantation rates of the embryo in IVF cases.
  5. PRP in Gyne-Aesthetics treatment: PRP injection in the vaginal will rejuvenate and regenerate the mucosal, muscles and skin as well as the vaginal vascularity. This will lead to greater increase in sensitivity and dramatically improve sexual life.  The surrounding skin  also become thicker and former making the vaginal and vulvar more pinkish and youthful. The ligaments and muscle will become stronger hence alleviating the problem of urinary incontinence!
In conclusion PRP is cheap, effective and safe alternative treatments in many medical conditions especially in Gynecology. Future researchs and trials will further explore the usefulness and efficacy of PRP in Gynecological disorder.