Impact of vaginal submucosal platelet-rich plasma combined with non-cross-linked hyaluronic acid injections on dyspareunia and sexual satisfaction in a Hodgkin lymphoma cancer survivor: a case report

Vaginal atrophy is a commonly encountered problem among young cancer survivors. Patients suffer from vaginal dryness, irritation, and dyspareunia secondary to oestrogen deficiency. Oestrogenbased hormone replacement therapy is effective, but unfortunately health concerns or contraindications in cancer survivors frequently limit its use. A 35-year-old female patient with dyspareunia that markedly affected her sexual relationship was referred to the gynaecology clinic. Treatment using topical oestrogen cream and sexual counselling were not successful. We treated her using two submucosal injections of PRP-non-cross-linked hyaluronic acid injections into the vestibule and lower third of the anterior vaginal wall mucosa, spaced a month apart. The patient reported marked reduction of dyspareunia and demonstrated an improvement of FSFI total score 1 month after the second injection. Both the patient and her husband showed an improvement of the index of sexual satisfaction score one month after the second injection compared to their pretreatment scores. Examination of the vaginal mucosa showed improvement of thickness and integrity of the mucosa and increased lubrication. PRP-non-cross-linked hyaluronic acid submucosal injections can be effective for cancer therapy-related vaginal atrophy, coitus-related pain, and sexual satisfaction.