Successful pregnancy and delivery following selective use of photodynamic therapy in treatment of cervix and vulvar diseases.

Abstract

Photodynamic therapy has been gaining popularity, particularly among young women. Therefore it is crucial to evaluate PDT for safety and its impact on fertility and delivery of healthy newborns. The study analyzed the PDT treatment of 10 young women, who suffered from diseases of the vulva and cervix. The aim of the analysis was evaluating what impact PDT treatment had on their pregnancies and delivery. 10 patients (22-32 years of age, 25.5 years of age on average) were treated with PDT in 2007-2014. 2 patients suffered from squamous cell hyperplasia, 2 patients from vulvar lichen sclerosus, 1 - genital warts, 1 - VIN I (current terminology: LSIL/Flat condyloma), 2 - CIN III (HSIL), 2 - CIN I (LSIL). The patients underwent photodynamic therapy (PDT). In the course of PDT the 5% 5- aminolevulinic acid was used in gel form three hours before irradiation. The affected areas were irradiated with a halogen lamp PhotoDyn 501 (590-760 nm) during a 10-min radiation treatment. The treatment was repeated weekly for 10 weeks. The median observation time period between the end of therapy and delivery was 3.92 years (2-7 years). None of the patients suffered from infertility. All patients gave birth to healthy, full-term infants. In case of one pregnancy cervical cerclage was needed. Two patients were treated for hypothyroidism caused by the Hashimoto disease. One patient had gestational diabetes. Two patients had already given birth to 2 children. Five patients gave birth by caesarean section. Topical PDT selectively used for treating the diseases of the female reproductive organs was applied in our group of patients and proved to be a safe method. It had no apparent negative impact on female fertility and allowed these women to give birth to healthy children.