A Novel Technique Combining Human Acellular Dermal Matrix (HADM) and Enriched Platelet Therapy (EPT) for the Treatment of Vaginal Laxity: A Single-Arm, Observational Study.

The article titled "A Novel Technique Combining Human Acellular Dermal Matrix (HADM) and Enriched Platelet Therapy (EPT) for the Treatment of Vaginal Laxity" by Yang et al. explores the clinical efficacy of combining HADM and enriched platelet therapy for addressing vaginal laxity. According to the study, this combination therapy is considered both safe and effective, showing improvements in vaginal tightness and sexual function. However, concerns arise regarding the methodology used for preparing and characterizing platelet-rich plasma (PRP). Specifically, the study lacks detailed information about platelet counts, a crucial factor for ensuring consistent and reliable treatment results. Additionally, the concentration of leukocytes and the platelet-to leukocyte ratio were not discussed, despite their potential impact on clinical outcomes. Variations in the use of activated versus non-activated platelets, as well as the substances used for activation, could influence results. Administering PRP gel throughan insulin syringe may also present challenges, and the activation of platelets couldlead to structural changes, causing the rapid release of growth factors. A more thorough analysis of these factors is necessary to establish more reliable conclusions on the application of PRP for enhancing female genitalia. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .