Objectives: Improving comfort during intercourse and vaginal dryness
Can improve the quality of life of patients in general, and in particular those treated for breast cancer.

Introduction: The injection of Hyaluronic Acid on the genital sphere represents an effective and simple and painless treatment. This procedure is practiced in the medical office. No need to go on surgical room.
It is an immediately effective treatment. It must be repeated every year.

FOR WHO:
After menopause, after treatment for breast cancer, sometimes even in young women (more and more often), sometimes after delivery, or a painful episiotomy,
The estrogen deprivation induce vulvovaginal atrophy, with vaginal dryness and dyspareunia.

NO MORE TABOO

Materials / method: After local anesthesia, injection of 1 seringue of HA on the vestibule and the lower third of the vagina.
Immediately effective, this treatment needs to be repeated approximately once a year.

Results: The majority of patients immediately feel better intimate comfort and 80% of couples find harmonious sexual activity after ten days.

Conclusion: This treatment is very easy and unpainful.
It has a strong impact on the sexual function and in the quality of life of Menopausal women or women even young after breast cancer.

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Objectives: Learning Objectives are to help delegates understand the importance of Post partum Pelvic Floor Rehabilitation to prevent POP, SUI and good pelvic strength for better intimate life, using HITS, HIFEM & FMS technologies.

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Objectives: To assess the effect of a series of treatments using Li-ESWT for mild to severe erectile dysfunction using IIEF & EHS scores before, 1 month, 3 month and 6 months post treatment.
To assess the effect of a series of treatments using Li-ESWT for women suffering from female orgasmic disorder using FSFI score before, 1 month, 3 months and 6 month post treatment.
To assess changes in symptoms using Li-ESWT in males and females with symptoms of overactive bladder syndrome 1 month, 3 month & 6 month post treatment.

Introduction: Li-ESWT is a well-established technology in medical specialties, including sexual medicine. Sexual dysfunction in Indonesia such as ED had 35% prevalence and Female Sexual Dysfunction had 78% prevalence. Li-ESWT promotes the repair and proliferation of blood vessels in the corpora cavernosum in male and females, and the entire vulval vasculature in females, to improve sexual function by induced neovascularization, angiogenesis and tissue remodeling in the endothelium and smooth muscles, endothelial growth factors & proliferating cell nuclear antigen.

Materials / method: Li-ESWT treatment was performed using electrohydraulic generated shockwaves. Device specifications; Shockwave: 40 µs pulse duration; EFD: 0.09mJ/mm2; Delivery rate: 160 pulses/min; Depth of penetration: 135mm.

9 male patients treated to 5 treatment points, 6 treatments were delivered across a 2 to 3-week period. Patients completed the IIEF questionnaire and EHS self-assessment before and after the treatment series.

5 female patients treated 4 to 6 treatment points were delivered across a 3-week period. Patients completed the FSFI before and after the treatment series.

Results: On Males
EHS: An increase of between 1-2 points was seen in all patients.
The total EHS, on average, was improved from 2.4 to 3.5. Of note, an increase of only 1 point from a score of 2 to a score of 3, allows the man to engage in penetrative sex, when they were previously unable. The total IIEF score, on average, was 45 pre-treatment and increased to 59 post a series of Li-ESWT treatments. The IIEF total available score is 75.
On females
The FSFI score was, on average, 21.4 points pre-treatment and increased to 31.3 post a series of Li-ESWT treatments. The FSFI total available score is 36.

Conclusion: Li-ESWT improves erectile function in Indonesian men suffering from erectile dysfunction, and most improvement was seen in men suffering from moderate erectile dysfunction. The results in the domain of erectile function on the IIEF, and the total EHS saw a substantial increase following a series of treatments with electrohydraulic generated Li-ESWT. Female patients saw an impressive increase on their FSFI score post treatment and reported notable improvement in ability to orgasm and improvement of pain during intercourse. High improvement in OAB in both genders.

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Objectives: To evaluate the efficacy and safety of polyneucleotides injection at vulvovaginal area for vulvovaginal rejuventation in younger, middle-aged and menopausal women.

Introduction: Factor effects changes in vulvovaginal area mostly from drop in estrogen hormone by physiological decrease from aging, cause of VVA symptoms.These symptoms worsened quality of life and their self-respect as still attractive women, and possibly the women’s couple relationship, may happen at a younger age, with vaginal dryness as an occasional side effect of OC. Polynucleotides (PN) may help for relieve vulvovaginal atrophy by increasing the hydration at vulvovaginal area and also increase lubrication of vaginal mucosa favoring the physiological regenerative and reparative mechanisms.

Materials / method: Case report study in women in younger, middle-aged and menopausal women who have vulvovaginal symptoms. Injected PN (20 mg/ml, medium viscosity) 2 ml at vulvar area, intradermal technique 3 sessions 4 weeks apart and injected PN (20 mg/ml, medium viscosity) 2 ml intramucosa at vestibule, labia minora, intravaginal area 3 sessions 4 weeks apart. Anesthetic cream applied before all infiltrations. Evaluations: basally and after 4, 8, 12 weeks.

Results: All women experienced decrease wrinkle, lifting, lightening, smooth and soft at vulvar area compare with before treatment via subjective and use photographs. Improvement in vaginal rejuvenation in vaginal dryness, dyspareunia, soreness.

Conclusion: PN are an efficient therapy for women suffering from vulvovaginal atrophy who suffering from vulvovaginal signs and symptoms affecting their quality of life. The study confirms that the PNs rationale retains its innovative potential and also confirms the safety and no complications.

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