Gynecologist and plastic surgeons pioneered the application of lasers in medicine and surgery almost 5 decades ago, initially used to treat cervical and vaginal pathologies. Ever since, energy-based devices have been deployed to treat pelvic pathologies and improve fertility. Recent technological developments triggered an unprecedented wave of publications, assessing the efficacy of fractional laser, and radiofrequency on the vaginal wall in reversing natural aging processes. Studies have shown that a certain degree of thermal energy deposited on the vaginal wall stimulates proliferation of the glycogen-enriched epithelium, neovascularization, and collagen formation in the lamina propria, and improves natural lubrication and control of urination. This review aimed to review such data and to guide future research. A unique assembly of experts from around the globe, compiled and edited this manuscript based on a thorough literature review and personal experience. Lasers Surg. Med. 49:137–159, 2017.

Background and ObjectiveUrinary incontinence (UI) is a common disorder that affects women of various ages and impacts all aspects of life. Our aim was to evaluate the non‐invasive erbium:yttrium‐aluminum‐garnet (Er:YAG) laser that exploits its thermal effect and has been used in reconstructive and rejuvenation surgery as a potential treatment strategy for stress UI (SUI) and mixed UI (MUI).Study Design/Materials and MethodsWe included 175 women (aged 49.7 ± 10 years) with newly diagnosed SUI (66% of women) and MUI (34%), respectively. Patients were clinically examined and classified by incontinence types (SUI and MUI) and grades (mild, moderate, severe, and very severe) using International Consultation on Incontinence Modular Questionnaire (ICIQ) and assessing Incontinence Severity Index (ISI). Using Er:YAG laser, we performed on average 2.5 ± 0.5 procedures in each woman separated by a 2 month period. At each session, clinical examination was performed, ICIQ and ISI assessed and treatment discomfort measured with visual analog system (VAS) pain scale, and adverse effects and patients’ satisfaction were followed. Follow‐ups were performed at 2, 6, and 12 months after the treatment.ResultsAfter the treatment, ISI decreased for 2.6 ± 1.0 points in patients diagnosed with mild UI before the treatment, for 3.6 ± 1.4 points in those with moderate UI, for 5.7 ± 1.8 points in those with severe UI and for 8.4 ± 2.6 in those with very severe UI (P < 0.001, paired samples t‐test). Altogether, in 77% patients diagnosed with SUI, a significant improvement was found after treatment, while only 34% of women with MUI exhibited no UI at one year follow‐up. Age did not affect the outcome. No major adverse effects were noticed in either group.ConclusionThe results of our study, have shown that new non‐invasive Er:YAG laser could be regarded as a promising additional treatment strategy for SUI with at least one year lasting positive effects. On the other hand, it does not seem appropriate for treating MUI. Lasers Surg. Med. 47:689–697, 2015. © 2015 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Objective: The aim of this randomized controlled trial was to evaluate the safety and efficacy of neodymium: yttrium aluminum garnet laser treatment of lichen sclerosus (LS) by comparing it with topical corticosteroid treatment.

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Background: The aim of this study is to evaluate effectiveness and safety of the use of ablative Er:YAG laser for removal of external genital warts (EGW), also called condylomata acuminata (CA).Methods: This is a retrospective cohort study performed at Gynecology Clinic Juna in Ljubljana, Slovenia. All patients older than 18 years that were clinically diagnosed with EGW and were treated with ablative Er:YAG laser between January 2012 and December 2017 were included in the study.Results: A total of 133 female patients (mean age 39.6 ± 12.9 years, range: 19–80) with EGW were eligible to be included in this study. EGW have been present from one to seven months, with a mean presence of 2.1 ± 2.0 months. The majority of the warts were on the labia, major some also on the mons pubis. The size of the lesions was 2–8 mm. The majority of patients, who completed therapy (74 patients out of 116; 64 %) received only one treatment and 82 % of the patients (n = 95) showed complete clearance of the lesions, without recurrence observed to date of analysis. Complete clearance was achieved after an average of 1.33 treatment sessions. Recurrence was reported by 21 patients (18 %). Recorded adverse effects of laser treatment were mild and transient.Conclusion: Er:YAG laser removal of EGW is a simple, quick and safe procedure, particularly suitable for large volume EGW or those that are located in anatomical sites difficult to access by other techniques.