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The CO2 ablative laser treatment in perimenopausal patients with vulvovaginal atrophy
Affiliations- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Poland
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Abstract
Objectives: The aim of the study was to evaluate the effectiveness of CO2 fractional laser therapy on perimenopausal urogenital symptoms. Material and methods: This prospective, open-label study included 205 patients who received three CO2 laser treatments. Clinical assessment was checked at baseline as well as at six weeks and 12 months post-treatment. The following scores were measured Vaginal Health Index Score (VHIS), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and assessment of the severity of selected urogenital symptoms. Results: Significant improvements in dryness, dyspareunia, burning, vaginal laxity, urinary incontinence, as were the results on the VHIS and ICIQ-UI SF at six weeks post-treatment (p < 0.05 for all scores), which were maintained through the follow-up visit at 12 months. No complications were observed either during or after laser therapy. Conclusions: CO2 ablative laser treatment can be effective in reducing vulvovaginal atrophy symptoms such as vaginal laxity, dryness, painful sexual intercourse, burning, and decreases the severity of stress urinary incontinence and urge incontinence symptoms. Positive results were maintained at 12 months after the laser treatment.
Abstract
Objectives: The aim of the study was to evaluate the effectiveness of CO2 fractional laser therapy on perimenopausal urogenital symptoms. Material and methods: This prospective, open-label study included 205 patients who received three CO2 laser treatments. Clinical assessment was checked at baseline as well as at six weeks and 12 months post-treatment. The following scores were measured Vaginal Health Index Score (VHIS), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and assessment of the severity of selected urogenital symptoms. Results: Significant improvements in dryness, dyspareunia, burning, vaginal laxity, urinary incontinence, as were the results on the VHIS and ICIQ-UI SF at six weeks post-treatment (p < 0.05 for all scores), which were maintained through the follow-up visit at 12 months. No complications were observed either during or after laser therapy. Conclusions: CO2 ablative laser treatment can be effective in reducing vulvovaginal atrophy symptoms such as vaginal laxity, dryness, painful sexual intercourse, burning, and decreases the severity of stress urinary incontinence and urge incontinence symptoms. Positive results were maintained at 12 months after the laser treatment.
Keywords
vulvovaginal atrophy; fractional CO2 laser therapy; perimenopausal period
About this articleTitle
The CO2 ablative laser treatment in perimenopausal patients with vulvovaginal atrophy
Journal
Issue
Article type
Research paper
Pages
374-380
Published online
2021-09-06
Page views
5597
Article views/downloads
918
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(5):374-380.
Keywords
vulvovaginal atrophy
fractional CO2 laser therapy
perimenopausal period
Authors
Anna Rosner-Tenerowicz
Aleksandra Zimmer-Stelmach
Mariusz Zimmer
References (29)- DiBonaventura M, Luo X, Moffatt M, et al. The Association Between Vulvovaginal Atrophy Symptoms and Quality of Life Among Postmenopausal Women in the United States and Western Europe. J Womens Health (Larchmt). 2015; 24(9): 713–722.
- Calleja-Agius J, Brincat MP. Urogenital atrophy. Climacteric. 2009; 12(4): 279–285.
- Lachowsky M, Nappi RE. The effects of oestrogen on urogenital health. Maturitas. 2009; 63(2): 149–151.
- Nappi RE, Palacios S, Panay N, et al. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey. Climacteric. 2016; 19(2): 188–197.
- Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010; 85(1): 87–94.
- Qaseem A, Dallas P, Forciea MA, et al. Clinical Guidelines Committee of the American College of Physicians. Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014; 161(6): 429–440.
- Haylen BT, de Ridder D, Freeman RM, et al. International Urogynecological Association, International Continence Society. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29(1): 4–20.
- Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl. 1990; 153: 7–31.
- Cavkaytar S, Kokanali MK, Topcu HO, et al. Effect of home-based Kegel exercises on quality of life in women with stress and mixed urinary incontinence. J Obstet Gynaecol. 2015; 35(4): 407–410.
- Schimpf MO, Rahn DD, Wheeler TL, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014; 211(1): 71.e1–71.e27.
- Cohen SR, Goodacre A, Lim S, et al. Clinical Outcomes and Complications Associated with Fractional Lasers: A Review of 730 Patients. Aesthetic Plast Surg. 2017; 41(1): 171–178.
- Karmisholt KE, Taudorf EH, Wulff CB, et al. Fractional CO laser treatment of caesarean section scars-A randomized controlled split-scar trial with long term follow-up assessment. Lasers Surg Med. 2017; 49(2): 189–197.
- Gaspar A, Addamo G, Brandi H. Vaginal Fractional CO2 Laser: A Minimally Invasive Option for Vaginal Rejuvenation. The American Journal of Cosmetic Surgery. 2011; 28(3): 156–162.
- Perino A, Calligaro A, Forlani F, et al. Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser. Maturitas. 2015; 80(3): 296–301.
- Salvatore S, Leone Roberti Maggiore U, Athanasiou S, et al. Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study. Menopause. 2015; 22(8): 845–849.
- Sokol ER, Karram MM. An assessment of the safety and efficacy of a fractional CO2 laser system for the treatment of vulvovaginal atrophy. Menopause. 2016; 23(10): 1102–1107.
- Salvatore S, Nappi RE, Zerbinati N, et al. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric. 2014; 17(4): 363–369.
- Athanasiou S, Pitsouni E, Antonopoulou S, et al. The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women. Climacteric. 2016; 19(5): 512–518.
- Murina F, Karram M, Salvatore S, et al. Fractional CO Laser Treatment of the Vestibule for Patients with Vestibulodynia and Genitourinary Syndrome of Menopause: A Pilot Study. J Sex Med. 2016; 13(12): 1915–1917.
- Pagano T, De Rosa P, Vallone R, et al. Fractional microablative CO2 laser for vulvovaginal atrophy in women treated with chemotherapy and/or hormonal therapy for breast cancer: a retrospective study. Menopause. 2016; 23(10): 1108–1113.
- Quick AM, Dockter T, Le-Rademacher J, et al. Pilot study of fractional CO laser therapy for genitourinary syndrome of menopause in gynecologic cancer survivors. Maturitas. 2021; 144: 37–44.
- Pieralli A, Bianchi C, Longinotti M, et al. Long-term reliability of fractioned CO laser as a treatment for vulvovaginal atrophy (VVA) symptoms. Arch Gynecol Obstet. 2017; 296(5): 973–978.
- Pitsouni E, Grigoriadis T, Tsiveleka A, et al. Microablative fractional CO-laser therapy and the genitourinary syndrome of menopause: An observational study. Maturitas. 2016; 94: 131–136.
- Sokol ER, Karram MM. Use of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause: 1-year outcomes. Menopause. 2017; 24(7): 810–814.
- González Isaza P, Jaguszewska K, Cardona JL, et al. Long-term effect of thermoablative fractional CO laser treatment as a novel approach to urinary incontinence management in women with genitourinary syndrome of menopause. Int Urogynecol J. 2018; 29(2): 211–215.
- Patel F. The Effects of RF Excited Fractional CO2 Laser on the Vaginal Canal in Treating Stress Urinary Incontinence [2G]. Obstetrics & Gynecology. 2017; 129(1).
- Salvatore S, Pitsouni E, Grigoriadis T, et al. CO laser and the genitourinary syndrome of menopause: a randomized sham-controlled trial. Climacteric. 2021; 24(2): 187–193.
- Ruanphoo P, Bunyavejchevin S. Treatment for vaginal atrophy using microablative fractional CO2 laser: a randomized double-blinded sham-controlled trial. Menopause. 2020; 27(8): 858–863.
- Cruff J, Khandwala S. A Double-Blind Randomized Sham-Controlled Trial to Evaluate the Efficacy of Fractional Carbon Dioxide Laser Therapy on Genitourinary Syndrome of Menopause. J Sex Med. 2021; 18(4): 761–769.
