New concept for treating urinary and sexual symptoms in women with vulvovaginitis by using Light-emitting Diode (LED): clinical study phase I

Pereira A1, Robatto M2, Pavie M2, Vilas Boas A2, Brito M3, Melo E4, Araújo E2, Campos G2, Lemos A2, Brasil C2, Gomes T5, Teles A2, Ferreira R2, Pires J6, Silva L2, Dantas L2, Pinto M7, Cerqueira M8, Pina M2, Sodre P9, Januario P10, Pessoa N2, Caetano S2, Lordelo P2

Research Type

Clinical

Abstract Category

Pelvic Pain Syndromes / Sexual Dysfunction

Abstract 276
ePoster 4
Scientific Open Discussion Session 20
On-Demand
Clinical Trial Pain, Pelvic/Perineal Pain, other
1. Escola Bahiana de Medicina e Saúde Pública, 2. Escola Bahiana de Medicina e Saúde Pública, Centro de Atenção ao Assoalho Pélvico, Instituto Patricia Lordelo, 3. Escola Bahiana de Medicina e Saúde Pública, Centro de Atenção ao Assoalho Pélvico,, 4. Pública Escola Bahiana de Medicina e Saúde Pública, Centro de Atenção ao Assoalho Pélvico, Instituto Patricia Lordelo, Faculdade Adventista da Bahia, 5. Escola Bahiana de Medicina e Saúde Pública, Centro de Atenção ao Assoalho Pélvico, Instituto Patricia Lordelo,, 6. Centro Universitário Estácio do Ceará, Faculdade IDE, 7. União Metropolitana para o Desenvolvimento da Educação e Cultura - UNIME, 8. Centro de Atenção ao Assoalho Pélvico, Instituto Patricia Lordelo, 9. Universidade do Estado da Bahia, Centro de Atenção ao Assoalho Pélvico, Instituto Patricia Lordelo, 10. Pública Escola Bahiana de Medicina e Saúde Pública, Centro de Atenção ao Assoalho Pélvico, Instituto Patricia Lordelo, Universidade do Estado da Bahia
Presenter
A

Ana Claudia Pereira

Links

Abstract

Hypothesis / aims of study
Vulvovaginitis is an inflammation or infection on the vulva and vagina region. This common condition affects women of all ages. The urinary and sexual symptoms may vary from dyspareunia, leucorrhoea, dysuria (among others) and have a negative impact on women's quality of life. In searching for non-pharmacological treatments, it is brought to light the hypothesis that light-emitting diode (LED) might be a therapeutic option. Phototherapy emits light in different wavelengths and has been used in the treatment of pelvic dysfunctions. (1) The wavelength variation causes a light color modification, therefore the effects of blue light may vary from  antimicrobial, anti-inflammatory and tissue regeneration purposes. This original study aims to describe clinical symptoms, sexual function and quality of life responses in women diagnosed with vulvovaginitis which were treated with blue LED (405nm).
Study design, materials and methods
This is a pilot study with 10 women (18-45 years old) with clinical diagnosis of vulvovaginitis. In a primary interview, the researchers collected all women's clinical and sociodemographic data, and also their sexual history. Afterwards, the FSFI and WHOQOL-Bref questionnaires were applied to measure sexual function and quality of life (respectively). Women with a suspected diagnosis of vulvovaginitis underwent clinical examination with a gynecologist. Additionally the examination of fresh vaginal sample, cervico vaginal cytology, pH measurement and culture-specific tests for fungus exames were collected. Upon vulvovaginitis confirmation, the participants underwent the 405nm blue LED application – power of 150 mW/cm2 and dose of 40.5 J/cm2, during 20 minutes. Figure 1 shows the LED device developed for this study (patent application number BR 10 2017 026980 9), as well as the light spectrum and the irradiation provided. The treatment consisted of three sessions with a 15-day interval between each one. All women were invited to return for a follow-up after 28 days. At this moment, they went through a clinical revaluation, as well as the reapplication of FSFI and WHOQOL-Bref.
Results
Fourteen patients with clinical complaint of recurrent vaginal discharge, associated with pruritus and diagnosed with vulvovaginitis were included in this study. Among these women, three were excluded for not adhering to the research protocol correctly. One participant was excluded because they had an intrauterine device (IUD). There was an improvement in the following symptoms – pruritus (6/8), leucorrhoea (4/9); dysuria (7/8), and dyspareunia (8/9). Table 1 shows the description of sexual function and quality of life of all 10 participants. It was verified that after 28 days of 405nm blue LED treatment 7 out of 10 women had an increase in the general score on both questionnaires.
Interpretation of results
Blue LED boosts the growth, metabolism and differentiation of microorganisms such as fungi and yeasts. This occurs as a result of photo-excitation of oxygen-dependent intracellular porphyrin molecules, causing oxidative damage and microbial cell death (2). Specifically in the genital region, these effects reduce clinical symptoms like vulvar erythema, pruritus, burning sensation, dysuria, dyspareunia and edema – without adverse effects (2). Multiple factors may interfere in the female sexual function – psychoemotional and physical, like genital tract infections. This single-arm pilot study revealed a change in the sexual function score (FSFI) and quality of life (WHOQOL-Bref), after the use of blue LED therapy in women with vulvovaginitis.
Concluding message
This original research revealed that blue LED was beneficial for treating vulvovaginitis symptoms (like pruritus, leucorrhoea, dysuria and dyspareunia), for improving sexual function and quality of life of women on a short term follow-up. These results might suggest LED as a new therapeutic option for treating problems associated with vulvovaginitis, however, clinical trials with bigger samples and methodological accuracy are recommended.
Figure 1 Table 1
Figure 2 Figure 1
References
  1. Robatto M, Pavie MC, Garcia I, et al. Ultraviolet A/blue light-emitting diode therapy for vulvovaginal candidiasis: a case presentation. Lasers Med Sci. 2019; 34(9):1819–1827. doi:10.1007/s10103-019-02782-9
  2. Maclean M, McKenzie K, Anderson JG, Gettinby G, MacGregor SJ. 405 nm light technology for the inactivation of pathogens and its potential role for environmental disinfection and infection control. J Hosp Infect. 2014;88(1):1–11. doi:10.1016/j.jhin.2014.06.004
Disclosures
Funding No funding received Clinical Trial Yes Registration Number The Clinical Trials registration number was NCT03500107 RCT No Subjects Human Ethics Committee Ethics Committee of the Bahiana School of Medicine and Public Health Helsinki Yes Informed Consent Yes
03/12/2021 20:23:03