Vaginal Injection of Platelet Rich Plasma for Sexual Function (VIP)

August 21, 2023 updated by: Medstar Health Research Institute

Vaginal Injection of Platelet Rich Plasma for Improvement of Sexual Function: A Randomized Control Trial

The goal of this clinical trial is to learn about an injection of platelet rich plasma into the vaginal wall and around the clitoris. The main questions it aims to answer are:

  • To see if a PRP injection improves sexual satisfaction
  • To learn the effect of PRP injections on sexual function Participants will get assigned to getting a one time PRP injection or a placebo injection. They will answer questionnaires about their sexual function at their first visit and their followup visit. The investigators will then compare the two groups.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Platelet-rich plasma is a substance derived from the participants' own blood and is not considered a drug. It is created through centrifugation of a participant's whole blood to separate out red blood cells leaving a concentrated plasma product containing the participant's natural endogenous growth factors and cytokines. PRP has been studied and found to be effective and safe without serious side effects in specialties such as orthopedics and dermatology. It is unclear if PRP injections to the anterior vaginal wall and clitoris improves sexual function and stress urinary incontinence. To date, the only literature on this is a single arm unblinded study.

This will be a single-blinded randomized controlled trial. Our primary objective is to determine if platelet rich plasma (PRP) injections into the anterior vaginal wall and periclitoral tissues boosts sexual satisfaction in sexually active women without a history of female sexual dysfunction (FSD). Our secondary objective is to determine the effect of PRP injections on sexual function. Qualifying subjects will be randomized 1:1 in permutated blocks to receive either PRP injection or placebo control (sterile saline injection). They will be followed for 6 month in the following fashion:

Visit #1: Screening, Baseline & Enrollment (virtual visit) This visit will be done virtually. Premenopausal sexually-active women meeting the listed inclusion criteria and exclusion criteria will view a short powerpoint orienting them to the research study and offer background about PRP and its proposed benefit for sexual function. Afterwards, a research team member will review the study and informed consent form, answer any questions, and, if they are interested in participating, the coordinator will obtain verbal informed consent and document verbal consent, and enroll the subject. The subject will then be asked to complete a series of questionnaires.

Visit #2: Randomization & Intervention (in-person visit) Subjects attending the in-person second visit will sign the informed consent form and then be randomized to either intervention (PRP) injection or placebo (injectable saline). The subject will be blinded to the treatment allocation.

- Blinding: This is a single-blinded study. The subject will not know whether they are giving or receiving PRP. The injector will be aware. The code will be broken only after the study is complete. At this point all the research team will be made aware of the results. During the study, the blinding may be broken only in emergencies when knowledge of the subject's treatment group is necessary for further subject management. When possible, the Investigator will discuss the emergency with the monitor (the IRB) prior to unblinding.

The unblinded research staff will complete the randomization in REDCap to obtain the treatment assignment. The subject will then undergo a venipuncture and 40 ml of blood will be obtained. If assigned to intervention, the blood sample will be centrifuged for 15 minutes and spun down according to the PRP kit preparation protocol for the Arthrex Angel system by trained and experienced research staff. On average, 2-4 cc of leukocyte-rich PRP is produced per 40 cc of whole blood. If assigned to the placebo arm, the blood sample will be properly disposed and the patient will receive 4 cc of injectable saline.

Injections will be performed as follows using a 25 gauge needle by a trained licensed provider with medical staff support. After positioning the patient and applying topical lidocaine to the vagina (applied for a minimum of 10 minutes), the vaginal tissues will be prepped and a total of 2-4 cc of allocated treatment will be injected into the distal anterior vaginal wall approximately 3 cm from the urethral meatus and in the peri-clitoral region. This injection will be superficial and just deep to the vaginal epithelium.

Visit #3 Follow-up (4 weeks +/- 7 days via virtual visit) The subject will complete the baseline questionnaire plus some additional questions. The subject will be asked about any AEs. This visit will be conducted virtually.

Visit #4 Follow-up (6 months +/- 14 days via virtual visit) The subject will complete the same questionnaire as in Visit #3. The subject will be asked about any AEs. This visit will be conducted virtually, unless the subject requests to be seen in person.

The data collected during the study will include the subjects' responses to validated questionnaires regarding sexual health/function. Basic demographic information will be collected at the first visit. These data will be obtained via an online survey and stored in a secure REDCap database.

Overall expected risks are anticipated to be rare in occurrence given no reported adverse reactions after vaginal PRP injections. Anticipated and known risks will be disclosed to the participants via the informed consent process. All study participants will be closely monitored for adverse events and at 50% enrollment a safety monitor will review all AE and safety data. All study investigators will receive training on the study protocol and AE monitoring.

An adverse event (AE) will be defined as any unfavorable or unintended symptom or sign, temporarily associated with an investigational intervention during the conduct of a clinical trial. Pre-existing diseases or conditions will not be considered AEs unless there is an increase in the frequency or severity, or change in the quality, of the disease or condition. Events that occur in patients treated with placebo will also be considered AEs. AEs will be recorded and serious adverse events will be considered an adverse events that either: (1) results in death, (2) is life threatening, (3) requires inpatient hospitalization, (4) results in permanent or significant disability or incapacity, or (5) is another medically important condition. All serious adverse events will be reported to the MedStar Health Research Institute (MHRI) IRB during which time study enrollment will be stopped and the safety monitor will conduct a review to assess safety of study continuation.

The investigators plan to recruit women via social media and in MedStar women's health clinics. For social media, the investigators will post the flyer on the local Facebook "Mom Group" pages. The investigators plan to post flyers in the waiting room and restrooms of the clinics. The investigators will post the flyers in the break rooms at MedStar Washington Hospital Center. Participants may also be referred by their clinical provider. Once they have expressed interest in the study, a member of the research team will contact them to screen for eligibility and discuss the study in detail. The investigators plan to recruit 52 participants.

Our sample size achieves 80% power to detect non-inferiority using a one-sided t test with significance level of 0.025. It is assumed that the true difference between the means is 0, standard deviation of the mean difference (mean score at 6 week follow up minus mean score at baseline) for both groups are considered to be 2.5 and 1.5 (based on previous studies of FSFI), and margin of non-inferiority is -1.8. This would be achieved with a sample size of 23 per treatment arm. Factoring in a dropout rate of 10%, each treatment arm will be 26 participants.

Statistical analysis will be by intent-to-treat. Comparisons will be performed using a t-test for continuous variables and chi-square or fischers exact for categorical variables as appropriate. The investigators will use different variables to determine if there are any significant associations using a univariate analysis that can be entered into a multiple logistic regression model, which will allow for the determination of independent predictors of outcome variables.

Study Type

Interventional

Enrollment (Estimated)

52

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • United States
    • District of Columbia
      • Washington, District of Columbia, United States, 20036

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 59 years (Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Menarchal women (assigned female at birth)

  • Age ≥ 18 years of age and <51

    · Sexually active with at least one episode of sexual activity per week defined as follows:

  • Partnered or solo penetrative or non-penetrative stimulation of the clitoris or vagina

    • English-speaking
    • Willingness and ability to comply with the study requirements

Exclusion Criteria:

  • Pregnancy
  • Pelvic organ prolapse (defined as symptomatic prolapse protruding beyond the hymen)
  • History of prior vaginal mesh or midurethral mesh sling surgery
  • History of pelvic radiation
  • History of or diagnosis of chronic pelvic pain
  • History of female genital mutilation
  • History of prolapse or incontinence surgery
  • History of genital tract malignancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Platelet Rich Plasma
Platelet Rich Plasma Injection
Other: Platelet Rich Plasma
Platelet rich plasma (PRP) is autologous blood which has been centrifuged to separate the supernatant resulting in a solution with high concentration of platelets. It is then injected into the anterior vaginal wall and periclitoral area
Other Names:
  • O Shot
Placebo Comparator: Saline
Placebo injection of saline
Other: Saline
Normal Saline to be injected into the anterior vaginal wall and periclitoral area

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sexual Function
Time Frame: 6 months
To determine if PRP injections into the anterior vaginal wall and peri-clitoral region alter sexual function or satisfaction in sexually active women without a prior history of FSD. This will be determine using the Female Sexual Function Index (FSFI) pre and post procedure. The FSFI is a validated questionnaire with 6 domains of desire, subjective arousal, lubrication, orgasm, satisfaction, and pain with a scale of 0-36. A higher score on this questionnaire correlates with higher sexual satisfaction.
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall effect
Time Frame: 6 months
To report the effect of PRP injection on sexual function using the Patient Global Impression of Improvement (PGI-I)The PGI-I is a validated global index that measures a response in a condition to a therapy. It is scaled 1-7, with 1 meaning very much improved.
6 months
Sexual Dysfunction
Time Frame: 6 months
To determine if PRP injections alter sexual distress/dysfunction. This will be determine using the Female Sexual Distress Scale (FSDS) pre and post procedure. The FSDS is a validated questionnaire with the domains desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. It is scaled 2-36, with lower scores indicating a higher symptom burden.
6 months
Pain with Injection
Time Frame: Day of procedure
To report the associated pain of a PRP injection. This will be done using the Visual Analog Scale (VAS). The VAS is a validated scale that is a subjective measurement of pain from a scale of 1-10, with 1 meaning no pain and 10 meaning worst pain
Day of procedure

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Medstar Health Research Institute

Collaborators

The Patty Brisben Foundation for Women's Sexual Health

Investigators

  • Principal Investigator: Alexis Dieter, MD, MedStar Health Research Institute

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 18, 2023

Primary Completion (Estimated)

May 1, 2024

Study Completion (Estimated)

August 1, 2024

Study Registration Dates

First Submitted

February 15, 2023

First Submitted That Met QC Criteria

March 13, 2023

First Posted (Actual)

March 15, 2023

Study Record Updates

Last Update Posted (Actual)

August 22, 2023

Last Update Submitted That Met QC Criteria

August 21, 2023

Last Verified

July 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • STUDY00005761

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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