Fractional CO2 Laser for Treatment of Vulvovaginal Atrophy: A Short Time Follow-up
Abstract
Objective: The aim of this study was to evaluate the safety and efficacy of fractional CO2 laser for treatment of vulvovaginal atrophy.
Materials and methods: In this clinical trial study, we evaluated the laser effect on vulvovaginal atrophy in 47 women aged 43-80 years. Each woman was treated with fractional CO2 laser, SmartXide2V2LR, DEKA, Monalisa Touch, vaginal 360o probe and cosmetic probe. The severity of vulvovaginal atrophy symptoms was evaluated before first session of laser and every 4 weeks after laser treatment until 12 weeks. Adverse effects including pain and itching were assessed at all visits. The statistical analysis was performed using SPSS version 23.
Results: The response to laser therapy for vaginal dryness was significantly (p <0.001) improved. Also, the response to laser therapy for each symptom include dyspareunia, vaginal discharge, itching and urge urinary incontinence was statistically significant (p <0.001) based on visual analogue scale (VAS).
Conclusion: It seems vaginal fractional CO2 laser can be applied as an effective and safe treatment method in genitourinary syndrome of menopause (GSM). It is necessary to conduct studies with long-term follow-up.
Nappi RE, Kokot-Kierepa M. Women's voices in the menopause: results from an international survey on vaginal atrophy. Maturitas 2010; 67: 233-8.
Krapf JM, Belkin ZR, Goldstein AT. Advances in the treatment of vulvovaginal atrophy. Expert Review of Obstetrics & Gynecology 2013; 8: 457- 65.
Portman DJ1, Gass ML; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Maturitas 2014; 21: 1063-8.
Weber MA, Limpens J, Roovers JP. Assessment of vaginal atrophy: a review. Int Urogynecol J 2015; 26: 15-28.
Kim HK, Kang SY, Chung YJ, Kim JH, Kim MR. The Recent Review of the Genitourinary Syndrome of Menopause. J Menopausal Med 2015;21:65-71.
Hutchinson-Colas J, Segal S. Genitourinary syndrome of menopause and the use of laser therapy. Maturitas 2015; 82: 342-5.
Asadi M, Jouyandeh Z, Nayebzadeh F. Prevalence of menopause symptoms among Iranian women. Journal of Family and Reproductive Health 2012; 6: 1-3.
Salvatore S, Nappi R, Zerbinati N, Calligaro A, Ferrero S, Origoni M, et al. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric 2014; 17: 363-9.
Zerbinati N, Serati M, Origoni M, Candiani M, Iannitti T, Salvatore S, et al. Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. Lasers Med Sci 2015; 30: 429-36.
Salvatore S, Roberti Maggiore UL, Athanasiou S, Origoni M, Candiani M, Calligaro A,et al. Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study. Menopause 2015; 22: 845-9.
Perino A, Calligaro A, Forlani F, Tiberio C, Cucinella G, Svelato A,et al. Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser. Maturitas 2015; 80: 296-301.
Department of Health and Human Services, Public Health Service, Food and Drug Administration. Electronic Engineering S.p.A. Mr Paolo Peruzzi. 2014.
Ahluwalia J, Avram MM, Ortiz AE. Lasers and energy‐based devices marketed for vaginal rejuvenation: A cross‐sectional analysis of the MAUDE database. Lasers Surg Med 2019; 51:671-7.
Baggish MS. Fractional CO2 laser treatment for vaginal atrophy and vulvar lichen sclerosus. Journal of Gynecologic Surgery 2016; 32: 309-17.
Arroyo C. Fractional CO2 laser treatment for vulvovaginal atrophy symptoms and vaginal rejuvenation in perimenopausal women. Int J Womens
Health 2017; 9: 591-5.
Pieralli A, Fallani MG, Becorpi A, Bianchi C, Corioni S, Longinotti M, et al. Fractional CO2 laser for vulvovaginal atrophy (VVA) dyspareunia relief in breast cancer survivors. Arch Gynecol Obstet 2016; 294: 841-6.
Siliquini GP, Tuninetti V, Bounous VE, Bert F, Biglia N. Fractional CO2 laser therapy: a new challenge for vulvovaginal atrophy in postmenopausal women. Climacteric 2017; 20: 379-84.
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: 1102-7.
Lang P, Dell JR, Rosen L, Weiss P, Karram M . Fractional CO2 laser of the vagina for genitourinary syndrome of menopause: Is the out-of-pocket cost worth the outcome of treatment? Lasers Surg Med 2017; 49: 882-5.
Gorbunova E. Apolikhin I, Sukhikh G. Laser in Gynecology: The First Russian Experience. Federal State Budget Institution Study presented at advanced course in genital rejuvenation & cosmetic gynecology - pre-congress courses - AMWC; Monaco2017.
Behnia-Willison F, Sarraf S, Miller J, Mohamadi B, Care AS, Lam A,et al. Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause. Eur J Obstet Gynecol Reprod Biol 2017; 213: 39-44.
Salvatore S, Nappi R, Parma M, Chionna R, Lagona F, Zerbinati N, et al. Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. Climacteric 2015; 18: 219-25.
Files | ||
Issue | Vol 14, No 2 (June 2020) | |
Section | Original Articles | |
DOI | https://doi.org/10.18502/jfrh.v14i2.4347 | |
Keywords | ||
Fractional CO2 Laser Menopausal Women Genitourinary Syndrome Vulvovaginal Atrophy |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |