Efficacy of fractional CO₂ laser in the treatment of genitourinary syndrome of menopause in Latin‐American Population: First Peruvian experience

Abstract

Objective This PUBA study aimed to assess the efficacy of fractional CO2 laser in the treatment of genitourinary syndrome of menopause (GSM). Methods GSM symptoms were assessed before, 1 month after the first session and 1 month after the third session of laser (3 sessions with a 30 days interval between them) in 60 women (median, interquartile range: 55, 49–69). Subjective (visual analog scale) and objective (Vaginal Health Index, VHIS; Vaginal Maturity Index/Frost Index; Spanish Overactive Bladder Questionnaire‐Short Form, USMEX Spanish OAB‐qSF and Female Sexual Function Index, FSFI) measures were used during the study period to assess CO2 fractionated laser treatment outcomes compared to baseline. Results Fractional CO2 laser treatment was effective to improve GSM symptoms (vaginal dryness, vaginal itching, vaginal burning, dyspaurenia, dysuria, urinary urgency; P < 0.001) after three sessions, as well as VHIS (median, interquartile range: 13, 10–15 at baseline vs. 21, 20–23 at the fourth month follow up; P < 0.001), Frost Index (median, interquartile range: 28, 24–31 at baseline vs. 8, 6–10 at the fourth month follow up; P < 0.001), USMEX (median, interquartile range: 56, 46–68 at baseline vs 14, 13–16 at the fourth month follow up: P < 0,001) and FSFI (median, interquartile range: 5, 2–14 at baseline vs 30, 28–32). Conclusions In this sample, the data suggests that fractionated CO2 laser is an effective alternative for GSM treatment with positive outcomes that persists over time. Lasers Surg. Med. 51:509–515, 2019. © 2019 Wiley Periodicals, Inc.

Review of non‐invasive vulvovaginal rejuvenation

“…QoL improved significantly in three studies . Urinary incontinence scores also improved significantly, and results were maintained for at least 3 months after treatment …”

“…However, most stated three laser treatments led to a superior score and sustained results. Four studies used the VMV . Three of these studies reported a significant increase in maturation value, while the fourth reported no difference .…”

“…All reported an improvement compared to baseline. Sexual function was reported to improve in thirteen studies . Improvement increased in proportion to the number of treatments and results lasted 6 months following the first treatment .…”

“…Sixteen studies used the VHIS . All reported a statistically significant improvement, regardless of whether it was one or up to three laser treatments.…”

“…Four studies used the VMV . Three of these studies reported a significant increase in maturation value, while the fourth reported no difference . One study reported using the vulvovaginal health index (VVHI) as separate to the VHIS .…”