Effect of the Fractional CO2 Laser on the Quality of Life, General Health, and Genitourinary Symptoms in Postmenopausal Women With Vaginal Atrophy: A Prospective Cohort

Adabi, Khadijeh; Golshahi, Fatemeh; Niroomansh, Shirin; Razzaghi, Zahra; Ghaemi, Marjan

doi:10.15171/jlms.2020.11

Cited by 24 publications

(38 citation statements)

References 25 publications

(39 reference statements)

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“…Previous reviews that assessed randomized controlled trials and observational studies also found evidence suggesting that laser treatment improves vaginal health, vaginal atrophy, and symptoms of urinary incontinence 3,59‐61 . However, it is believed that no previous review has been conducted on studies using radiofrequency.…”

Section: Discussionmentioning

confidence: 99%

“…During this period, there is a decrease in circulating estrogen, which provokes thinning of the vaginal epithelium and a reduction in its collagen content, hyalinization, and elastin content, thereby increasing the connective tissue density and reducing the vascularity of the vagina. This can lead to burning, fissuring, dyspareunia, and postcoital bleeding 3 …”

Section: Introductionmentioning

confidence: 99%

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Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Sarmento

Lírio

Medeiros

et al. 2021

Intl J Gynecology & Obste

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Background Genitourinary syndrome of menopause (GSM) negatively affects sexual function and quality of life. Techniques like laser and radiofrequency are being used to manage GSM, particularly in women with contraindications for hormone therapy. Objectives To verify whether the physical methods of laser and radiofrequency can be recommended as safe and effective options for the treatment of GSM/urinary urgency or incontinence in pre‐ and postmenopausal women. Search strategy Databases were comprehensively searched using combinations of the following keywords in any language: “postmenopause”; “genitourinary syndrome of menopause”; “vaginal atrophy”; “radiofrequency”; and “laser.” Selection criteria Full articles of case‐control, cross‐sectional, cohort, randomized clinical trials, and quasi‐randomized or controlled clinical trials were included. Data collection and analysis All authors independently evaluated the design of the studies for quality of reporting, risk of bias, and quality of evidence. Main results Of the included 49 studies, 37 were on the CO2 laser, 10 on the Erbium laser, and two on radiofrequency. Conclusions Laser and radiofrequency therapy could be promising and safe therapeutic options for GSM/urinary incontinence. However, the study findings cannot be generalized until new randomized clinical trials are performed that confirm the strength of the evidence. This review has been registered with PROSPERO: CRD42020141913.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Sarmento

Lírio

Medeiros

et al. 2021

Intl J Gynecology & Obste

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“…As previously mentioned, numerous studies have noted significant improvement in GSM, VL, sexual function, and QOL following treatment with vaginal CO 2 laser therapy (Table 1) [20,22,23,38,39,42]. Improvement in urinary incontinence has not been reported with CO 2 laser therapy.…”

Section: Co 2 Lasermentioning

confidence: 96%

“…A more recent prospective cohort study by Reisenauer et al [49] reported that among patients (N=30) receiving two treatments with Er: YAG laser therapy, patients reported a significant improvement in QOL, which had previously not been reported. [38].…”

Section: Erbium:yttrium-aluminum-garnetmentioning

confidence: 99%

Energy-Based Devices for Functional Vaginal Problems: Issues and Answers

Bujnak

Crowder

Krychman

2021

Curr Sex Health Rep

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Vaginal rejuvenation is a marketing term that encompasses surgical and medical treatments for functional vaginal/vulvar problems including but not limited to genitourinary syndrome of menopause (GSM), sexual dysfunction, vaginal laxity, and stress urinary incontinence (SUI) and for esthetic concerns including dissatisfaction with vulvovaginal appearance. Multiple treatment options have become available for indications of functional vaginal problems. Noninvasive management options including the use of more novel treatments such as energy-based devices have gained interest. Previously, studies regarding the efficacy and safety of the energy-based devices for functional vaginal problems were mostly limited to cohort studies without sham treatment, control groups, randomization, or double blinding. As a result of this insufficient data in 2018, the FDA released a statement of warning against the use of energy-based devices in the treatment of functional vaginal problems or vaginal cosmetic procedures (Https://Www.Fda.Gov/Medical-Devices/Safety-Communications/Fda-Warns-Against-Use-Energy-Based-Devices-Perform-Vaginal-Rejuvenation-or-Vaginal-Cosmetic. 1–4, 2018). Purpose of Review This article reviews the most current treatment modalities in the realm of vaginal rejuvenation therapy with an emphasis on the efficacy and safety of the energy-based devices. Recent Findings In the most recent literature, there have been studies with improvements in study design that support the efficacy and the short-term safety of the energy-based devices. Summary More recent studies with improved study design evidence that the use of energy-based devices results in improvements in functional vaginal problems and that serious adverse events appear to be rare. The availability of these devices as treatment options for functional vaginal problems has the potential to impact patient by improving their symptoms and quality of life. Caution still remains however regarding their safety following a longer period of time after their use.

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“…Intravaginal laser therapy is a new non-pharmacological treatment successfully proposed especially for the management of symptoms produced by menopausal genital atrophy. Due to the satisfactory efficacy of this treatment, the term “vaginal rejuvenation” has been proposed by some authors [ 24 , 25 , 26 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Results of a Phase I-II Study on Laser Therapy for Vaginal Side Effects after Radiotherapy for Cancer of Uterine Cervix or Endometrium

Perrone

Tesei

Ferioli

et al. 2020

Cancers

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Women who have previously received radiotherapy (RT) for gynecologic cancer often suffer from vaginal fibrosis and stenosis. The success of “non-ablative” laser therapy for postmenopausal vaginal atrophy has led to the idea of testing the laser in patients submitted to RT. In this prospective observational study, we selected patients who underwent pelvic RT followed by vaginal laser treatment. We scheduled three treatment sessions (at T0–T1–T2) and three controls (at T1–T2–T3) one month apart. The follow-up (at T4) was carried out six months after the last treatment. Vaginal Health Index (VHI) and vaginal length were evaluated. Sexual function was assessed through Female Sexual Function Index (FSFI). Overall, 43 patients with severe vaginal shortening, atrophy and stenosis was enrolled and treated with intravaginal non-ablative CO2 laser. We observed a progressive increase in vaginal length of 9% (p = 0.03) at T2 and 28% (p < 0.0001) at T3; effects were maintained at T4 (p < 0.0001). After the first application VHI showed a significant improvement of 57% at T3 (p < 0.0001). The results were maintained at T4 (p < 0.0001). No changes were found in FSFI. All procedures were well tolerated. In conclusion, laser therapy improved vaginal length and VHI in women undergoing pelvic RT; prospective studies are needed.

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Effect of the Fractional CO2 Laser on the Quality of Life, General Health, and Genitourinary Symptoms in Postmenopausal Women With Vaginal Atrophy: A Prospective Cohort

Cited by 24 publications

References 25 publications

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Energy-Based Devices for Functional Vaginal Problems: Issues and Answers

Results of a Phase I-II Study on Laser Therapy for Vaginal Side Effects after Radiotherapy for Cancer of Uterine Cervix or Endometrium

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