Vaginal Platelet-Rich Plasma and Vaginal Histology in Genitourinary Syndrome of Menopause

This study evaluates whether subepithelial injection of autologous platelet-rich plasma (PRP) into the vaginal wall produces histological changes consistent with tissue regeneration in postmenopausal women with genitourinary syndrome of menopause (GSM). Women with GSM and concomitant pelvic organ prolapse who were scheduled for reconstructive prolapse surgery received two treatment sessions four weeks apart. Within each participant, three predefined vaginal regions received PRP injection, normal saline injection or no intervention. At the time of prolapse surgery, four weeks after the second session, biopsies were obtained from all three regions and assessed by a pathologist blinded to treatment allocation. Epithelial thickness, epithelial glycogen content, epithelial proliferative activity, vascular density, subepithelial papillae and collagen architecture were compared among the three sites.