Training village - Dr Durantet

WELCOMETraining village

PERFORM EASY AND PAINLESS VAGINAL

DRYNESS TREATMENT WITH ELEA®

D r B e r t r a n d D u r a n t e t A e s t h e t i c D o c t o r

LY O N – F r a n c e

w w w. d r - d u r a n t e t . c o m

FEATURES ON ELEA®

PART 1

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THE MAGNETIC SUPPORT

THE FOOT PEDAL

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THE PEN

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« Bolus » mode

2 INJECTION MODES

« Cont inuous » mode

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Low speed ( 0 ,3 m l / mn )

Med ium speed (0 ,6 m l / mn)

H igh speed (1 ,2 m l / mn )

3 CONSTANT COLORS

FOR

3 SPEEDS OF INJECTION

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S m a l l v o l u m e ( 1 2 , 5 µ L )

Med ium vo lume (8 µL)

H igh vo lume (4 ,5 µL)

3 LIGHTENING COLORS

FOR

3 VOLUMES OF INJECTION :

With1 mL of HA : - 80 big drops

- 120 medium drops - 230 small drops

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MANUAL VS ELECTRONIC INJECTION

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SMART VOLUME SYSTEM

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… For the patients • Significant reduction of pain • Reduction of side effects • Faster recovery • Reassuring practice

MANY ADVANTAGES

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… For the practitioners • High precision • Less muscle fatigue • Better injection speed control • Accurate injected volume control • Optimization of consumables • High Tech image

MANY ADVANTAGES

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LIGHT – ACCURATE – INTUITIVE

COMFORTABLE – REASSURING – GRACEFUL

ELEA® FOR THE TREATMENT OF VAGINAL DRYNESS

PART 2

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Intra-mucous injection of crosslinked HA In order to biostimulate/ rehydrate the genital mucosa’s superficial layers

• Troph ic : ⇒ Vu l v o v a g i n a l a t ro p h y ⇒ I n t i m a t e d i s c o m f o r t s , d y s p a re u n i a ,

B u r n s , d r y n e s s

• Fonct iona l : ⇒ S e c o n d a r y t o t ro p h i c i s s u e s :

S e x u a l i t y d i s o rd e r s : « F e m i n i n e s e x u a l d y s f u n c t i o n »

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TREATMENT GOALS

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Ind icat ions


VAGINAL REHYDRATION

Postmenopausal mucosal atrophy

Iatrogenic mucosal atrophy

Painful or fibrotic perineal scar

Vulvovaginal dryness of the young woman

Postpartum

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Cont ra ind icat ions


VAGINAL REHYDRATION

Same as for HA injections

Vaginal infections in progress

Menstruation

• Allergy to HA • Systemic disease (neoplasia) • Unstable autoimmune disease • AAR with cardiac localization • Pregnant or lactating woman • Non-resorbable implants

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✓ Case o f sc leroat roph ic vu lvar l ichen :

• A u t o i m m u n e d i s e a s e ( c h ro n i c i n f l a m m a t i o n ) • C o n t r a i n d i c a t e d f o r H A i n j e c t i o n s . • Tre a t m e n t o f re l a p s e s : d e r m o c o r t i c o i d . = > B u t a g g r a v a t e s m u c o c u t a n e o u s a t ro p h y. • B i o p s y e s s e n t i a l t o c o n f i r m t h e d i a g n o s i s . • A H i n d i c a t i o n : - D i s e a s e c o n f i r m e d b y b i o p s y - D i s e a s e s t a b i l i z e d f o r 5 y e a r s ( n o s y m p t o m a t o l o g y / d e r m o c o r t i c o i d b e c o m e u s e l e s s ) .


VAGINAL REHYDRATION

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Burns

Dyspareunia

Per-coital pain

Intimate drought

Vaginal irritation

Bleeding during intercourse

Permanent discomfort

Itching, pruritus

Smooth white or zebra patches

Tendency to bruises, cracks

CLINICAL EXAMINATION


CLINICAL EXAMINATION

Pale & atrophic appearance of the vulvovaginal mucosa

Vestibulodynia (cotton swab test)

Drought

Petechiae

Contact bleeding

Loss of elasticity

Loss vaginal ridges

Associated genitourinary syndrom

clear urine cystitis, non-infectious VV pruritus, unpleasant odours, hyperlaxity and urinary incontinence

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ATTENTION !

ACHTUNG !

ATENCIÒN !

ATTENZIONE !

BE CAREFUL !


REMINDER HISTOLOGY

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Arteries :

✓ Upper part of the vagina :

• Vesico-vaginal a. (uterine a. branch)

• Cervico-vaginal a. (idem)

✓ Medium & lower part of the vagina :

• Long vaginal a. (hypogastric a. branch) • Middle rectal a. & internal pudendal a.


REMINDER : VASCULARIZATION

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1 . I f he rpe t ic backgroud (even bucca l ) : => ZELITREX® : 1 cap / day 3 days p r io r and a f te r. 2 . C lean ing and d is in fec t (gynaeco log ica l be tad ine®) 3 . Loca l anaes the t ic o f the pos te r io r vag ina l fo rk 4 . On ly in jec t the pos te r io r vag ina l l i n ings , the ves t ibu le ( junc t ion be tween lab ia m inora and vag ina) and the lab ia ma jo ra . 5 . 2 -3 cm deep f rom the vag ina ’s o r i f i ce on ly


INJECTION PROTOCOLE (1/2)

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6 . In jec t ion w i th an HA f i l l e r s l igh t l y c ross l inked (CE mark ing) 7 . M ic ro -papu les techn ique (submucous) 8 . Ver y super f ic ia l i n jec t ions : 0 ,5 to 1 mm deep. 9 . A lways s tay para l le l to the mucous p lan 10 . 0 ,05 to 0 ,1 m l per bo lus , mean ing 10-20 in jec t ions 11 . 0 ,5 - 0 ,8 m l fo r the l i n ings / 0 ,2 – 0 ,5 m l fo r the ves t ibu le & lab ia ma jo ra 12 . 30 G ye l low need le recommended


INJECTION PROTOCOLE (1/2)

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• Ins is t on the a t roph ic zones and ep is io tomy scars .

• Lab ia ma jo ra ’s in jec t ion poss ib le (bo lus o r re t rograde techn ique)

• Do no t in jec t the lab ia m inora

• An t ib io t ic coverage non sys temat ic


INJECTION PROTOCOLE TIPS

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Do no t in jec t : • In t ravascu la r l y ( IV )

• The c l i to r i s

• Caver nous bod ies

• The an te r io r l i n ing • The lab ia m inora

• The Bar tho l in ’s g lands

ATTENTION ! ACHTUNG ! ATENCIÒN ! ATTENZIONE !

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REMINDER

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• In f lammat ion , • Redness , • Œdema, • Harden ing , • Nodu le , • S l igh t b leed ing , • Hematoma, • Bout o f he rpes .


COMPLICATIONS (RARE)

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=> From Month 1 & maximum to Month 3 :

Reduct ion o f :

• Dyspareun ia

• Vag ina l d r yness • Mucosa ’s a t rophy • Vag ina ’s pH

• Repet i t i ve vag in i t i s


RESULTS

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• Study made in 2012 on 8 pa t ien ts :

80% enhancemen t d r yness / i r r i t a t i ons

• Study made on 52 pa t ien ts ( re touch a t Month 1 in 47%) :

94 % o f women no t i ce an improved o r h igh l y improved qua l i t y o f l i f e up t o 6 mon ths a f t e r t rea tmen t .


RESULTS

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• No swimming / sauna / jacuzzi for the following 48 hours. • No sexual intercourse for 4 – 5 days after treatment. • No cycling, gymnastics or horse riding for 7 days. • PREMENO Ovule® (hyaluronic acid + lactic acid) :

1 pill at bedtime for 10 days, 1 taking every 3 days for maintenance, to be continued accordingly to intimate comfort.


POST-INJECTIONS REMINDERS

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In my practice, the use of the pen injector allows :

• More precision with the “pen style” (support points) • Easy to go inside the vagina with the long grip • Less painfull with speed & flow control than manual injection • To be concentred on my injection (no looking at the graduation) • To have enough product to treat a large area (Vagina, vetibule and the Big Lips) • To avoid big papula • No muscular fatigue


MY ADVANTAGE OF USING ELEA

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INJECTION PROTOCOLE WITH ELEA


VIDEO DEMONSTRATION

PART 3

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THANK YOU

Dr Ber trand DURANTET Aesthet ic doctor LYON - FRANCE

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Training village - Dr Durantet