Depth Matters: The Use of Radiofrequency for the Treatment of Gynecologic Conditions [40G]

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The use of radiofrequency (RF) energy administration to the vaginal canal has been increasing, but questions regarding safety and mechanism of action remain. The type of RF, mode of administration and protocol will impact treatment outcomes. Submucosa cellular changes require that energy penetrate deep into the tissue without causes damage to the mucosal tissue. Data indicate that cryogen-cooled monopolar radiofrequency (CMRF) treatment elicits changes such as fibroblast activation and neocollagenesis while being safe to patients


Ovine ex vivo and in vivo studies were performed to investigate the depth of penetration and safety of CMRF treatment. Ex vivo treatment was performed on isolated vaginal and peri-vaginal tissue at different regions of the vagina. Gross observations and histopathological analyses were performed. Tissue was isolated following RF treatment and analyzed for tissue effects. Outcome measures include temperature monitoring and histopathology to evaluate the extent of treatment, cellular changes and safety.


Data indicate that there are a number of cellular changes in the submucosal layers of the vagina following elevated temperature of these tissues and that these modifications result in increased structural integrity and function. Such changes are likely responsible for clinical benefit reported. In addition, when an energy titration experiment was performed with ex vivo tissue, there were no adverse tissue effects observed.


The type of RF energy and mode of delivery will have an impact on the tissue affected and the potential clinical benefit. CMRF energy affects the deeper connective tissue in the vaginal canal while protecting the mucosal tissue

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