Autologous Fat Grafting Combined With Platelet-Rich Plasma in the Treatment of Female Genitourinary Aging: A Retrospective Study

Background Female genitourinary aging (due to childbirth, menopause, weight changes, aging) causes genital shrinking, vaginal laxity, dyspareunia, and urinary issues, impairing quality of life. Current treatments (lubricants, hormone creams, laser) are temporary, have drawbacks, or lack clear guidelines. Autologous fat grafting (AFG) enables safe volumization, and platelet-rich plasma (PRP) promotes tissue repair, but evidence for their combination here is scarce. Objectives To explore the clinical efficacy and safety of AFG combined with PRP in female external genitalia and vaginal rejuvenation. Methods A retrospective study included 38 patients (Jan 2020–Dec 2024) with genital/vaginal aging who received combined AFG (mons pubis, labia majora, G-spot, perineum) and PRP. Postoperative evaluations were performed with the Vaginal Laxity Questionnaire (VLQ) and the Female Sexual Function Index (FSFI), and complication monitoring was conducted. Results Post-operativeVLQ scores rose from 2.45 ± 0.81 to 5.03 ± 1.15 (P = 0.027). All 6 dimensions of the FSFI (sexual interest, sexual arousal, vaginal lubrication, orgasm, sexual satisfaction, dyspareunia) and the total FSFI score also significantly improved (all P < 0.05), with a mean total FSFI increase of 9.0 ± 2.3 points (a ≥4-point increase is clinically meaningful). 92.1% (35/38) were “very satisfied” with appearance/tightness. Only 2 (5.3%) experienced mild redness (resolved with oral antibiotics); no severe complications occurred. Conclusions In this small cohort with limited follow-up, autologous fat grafting combined with PRP treatment appear to improve the external appearance of female external genitalia and vaginal aging and enhance genital function, improve patient-reported sexual function (based on FSFI) and reduce urinary system problems.