VAGINAL COMBINED THERAPY

A NEW APPROACH TO VAGINAL INFECTIONS

DR. DAN CALMAN DR. DAN CALMAN

Dr. DAYAN – HOLISTIC MEDICAL Dr. DAYAN – HOLISTIC MEDICAL CENTERCENTER

Vaginal Infections

The frequency of Vaginitis is difficult to ascertain. General Gynecologic clinics: 5-15% STD clinics: 32-64%

In theIn the U.S.A.U.S.A.

Causes of Vaginitis

InfectiousInfectious Candidiasis Trichomoniasis Viral Infs. Desquamative Inflammatory

Vaginitis (Clindamycin responsive)

Foreign Bodies Parasitic

Noninfectious Atrophic Vaginitis Allergic Vaginitis Collagen Vascular Dis.

(Behçet’s syn., Pemphigus)

Most Common Causes Of Vaginitis

Bacterial Vaginosis (22-50%)Bacterial Vaginosis (22-50%)increased numbers of organisms such as Gardnerella vaginalis,

Bacteroides, Mobiluncus, and Mycoplasma hominis . Trichomoniasis (4-35%)Trichomoniasis (4-35%)single-celled protozoan parasite Trichomonas vaginalis. Trichomonas is associated with many perinatal complications and an

increased incidence of transmission of HIV. Vaginal Yeast Infection& Candidiasis (17-39%)Vaginal Yeast Infection& Candidiasis (17-39%)Vaginal candidiasis, Fungal infection of the vagina, sometimes called

thrush. Approx. 75% of women will experience an episode of vulvovaginal

Candidiasis

Recurrence Rate

Vulvovaginal candidiasis – Chronic or reccurent infections (4 or more infections per year) may occur in 5% of the population.

RECCURENT DISEASE IS MORE DIFFICULT TO TREAT !!!!!

Bacterial Vaginitis- About 30% of patients have recurrence within 3 months.

As a result of recurrent treatment some pathogenic strains develop antibiotic resistance.

THIS CALLS FOR

A NEW APPROACH TO VAGINAL INFECTIONS !!!!!!!

Hyperthermia

Some pathogens fail to survive at high temperature levels.

Hyperthermia (Cont.)

CandidaCandidaExtremely vulnerable to heat.At high temperature Candida transforms into

its protective form (hyphae). If not treated in 3 weeks it will return to its

original form. Thus, the second session should be performed

exactly 3 weeks later.

Hyperthermia (Cont.)

T. VaginalisT. Vaginalis

Succumbs to temperature above 40ºC, and dies in not more than 35-40 minutes.

Hyperthermia eradicates bacterial and eradicates bacterial and yeast infectionsyeast infections

High temperature causes VasodilatationVasodilatation and enhanced blood supply to the vagina.

High Temperature causes regeneration of regeneration of epitheliumepithelium of the vaginal walls.

Hyperthermia (Cont.)

Medispec Ltd.’s GynathermTM

Treatment is performed by inserting a probe into the patient’s vagina, the probe being heated gradually by circulating water.

Gynatherm All Over The Globe – Partial List

Denmark Brazil Switzerland Sweden Portugal Italy Guatamala Hong-Kong China Russia Ukraine

Safety

An animal study in a canine model demonstrated no thermal damage to the vaginal epithelium. (Factor, J; 1993, Beilinson)

Effectiveness

An animal study in a canine model demonstrated negative post treatment cultures in initially infected ( Chlamydia & Trichomonas) dogs (Factor, J; 1993, Beilinson)

Vaginal Heating Success Rate

Di Fraia, A.: 43-47ºC for 20 min. sessions (3-6 sessions) – 91.3%

Kaplan, B.: 43-49C for 20 min. sessions (x2) - a significant improvement was found in 77 % of patients., both objectively and subjectively.

Ozone

A molecule that manifests bactericidal, virucidal and fungicidal actions.

First World War- ozone’s bactericidal properties were used to treat infected wounds, mustard gas burns and fistulas.

Ozone’s applications: wounds, fistulas, decubitus ulcers, osteomyelitis, burns, staph. Infections, fungal and radiation lesions, Herpes simplex and Zoster, gangrene

Ozone (Cont.)

High ozone concentrations – for disinfection and debridment.

Low ozone concentrations – promote epithelialization and healing.

Ozone’s T1/2 is 45 min. at 20ºC, losing its concentration to 16% of its initial value in 2 hours.

Ozone has a very high diffusion coefficient into tissues.

As a result – OZONE SERVES AS OXYGEN’S OZONE SERVES AS OXYGEN’S SECONDARY MESSENGER TO TISSUES.SECONDARY MESSENGER TO TISSUES.

Ozone’s Curing Potential

Antibacterial Antibacterial effect Enhancement of Oxygen saturationEnhancement of Oxygen saturation in

tissues

Both Treatment Methods

Stand on their own as effective modes of treatment for recurrent /chronic Vaginitis

Combination Therapy

(Vaginal douching with low concentration Ozone)

+

(Vaginal Hyperthermia with the Gynatherm)

=

EFFECTIVITY EFFECTIVITY ENHANCEMENT !!!!!ENHANCEMENT !!!!!

Estimated Mechanism

Heat Vasodilatation Vaginal blood supply (and O2) Enhancement+ Bacterial Eradication

Ozone Enhanced O2 supply to the tissue+ Bacterial Eradication

Estimated Mechanism (Cont.)

Both treatment methods enhance bacterial eradication + vaginal tissue regeneration

Treatment Protocol

Research Protocol (anamnesis, physical exam., PAP smear, microbiological culture)

3-6 treatment sessions with 3 weeks interval. First treatment after the first menstruation. Prior to treatment the vagina is washed with 30ml of

dissolved Ozone. Probe is applied at body temperature for 1-2 min. for

adaptation Temperature is raised up to 49ºC for 18-19

additional min. (total of 20 min)

Treatment Protocol (Cont.)

Next treatments should be administered in the same application of temperature and time.

Between thermotherapy sessions, once every 10 days vaginal enemas with low concentration ozone gas are performed.

Our Medical Center Success Rate

75-80% improvementNo AE reported

Conclusion

We find combined Thermal + Ozone therapy safe and highly effective for the treatment of Recurrent / Chronic Vaginitis.

Long-term follow-up is needed to elucidate effectivity of treatment.

Further cooperation between medical centers should be encouraged for additional data collection.

THANK YOU !!!!!!