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 !!!!!!