The Effect of Fractional CO₂ Laser Treatment on the Symptoms of Pelvic Floor Dysfunctions: Pelvic Floor Distress Inventory‐20 Questionnaire

Abstract

Background and Objectives To assess the improvement on pelvic floor distress (PFD)‐related urogenital symptoms using validated questionnaires after intravaginal CO2 laser treatment. Study Design/Materials and Methods Forty postmenopausal women with genitourinary symptoms of menopause (GSM) were enrolled into this prospective cohort study and underwent vaginal laser treatment using MonaLisa Touch® fractional CO 2 laser system. Patients received three vaginal laser treatments with 360° probe 4 weeks apart. A three‐component Pelvic Floor Distress Inventory (PFDI‐20) validated questionnaire was filled out by each patient before each session and 4 weeks after the final treatment. Wilcoxon rank sum test was used to compare the before and after treatment scores. Results Pelvic Organ Prolapse Distress Inventory (POPDI‐6) scores were not significantly different after the first treatment compared with baseline (mean ± standard deviation [SD], 21 ± 18 vs. 17 ± 15, P = 0.44). However, each subsequent treatment resulted in further, statistically significant improvement in symptom scores (14 ± 15, P = 0.03 and 13 ± 13, P = 0.01, after the second and third treatments, respectively). Similarly, Urinary Distress Inventory (UDI‐6) scores were not significantly different after the first laser treatment (mean ± SD, 36 ± 25 vs. 29 ± 23, P = 0.36). After the second and third treatments there were significant improvement in the standardized scores (24 ± 20, P = 0.03 and 22 ± 21, P = 0.01). Colorectal‐Anal Distress Inventory (CRADI‐8) scores did not change significantly after three laser treatments. Conclusions Three sessions of microablative fractional CO2 vaginal laser treatment significantly improves patient reported urinary and pelvic organ prolapse symptoms. Lasers Surg. Med. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

The Efficacy and Safety of CO2 Laser Treatment for Sexual Function and Vaginal Laxity Improvement in Pre‐Menopausal Women

“…This study showed that the positive effects of laser treatment on vaginal laxity and sexual function waned by 6 months. A significant subjective improvement and the partial objective improvements observed at 3 months after 3 treatment sessions, and the decline during the subsequent 3 months post‐treatment collaborate the results of previous case series [14–36]. The objective parameter assessed (VHI) declined to pre‐treatment baseline levels at 6 months, while subjective parameters (FSFI and monthly sexual intercourse rate) demonstrated a slower, though significant decline at 6 months.…”

“…All tests were considered significant at the 0.05 level. The sample size was based on previous studies that showed a statistically significant change following laser treatment [15–36].…”

“…The various modalities of laser treatment have been studied in several clinical case series. Laser devices have been utilized in the treatment of genitourinary syndrome of menopause, vulvovaginal atrophy, female stress urinary incontinence, vaginal rejuvenation/tightening and vestibulo/vulvodynia, with varying rates of efficacy [15–39].…”

The Effect of Vaginal Microablative Fractional CO2 Laser Treatment on Vaginal Cytology

“…Most recently vaginal laser treatment was introduced as a new option for women with GSM and vaginal dryness. Several clinical studies have investigated the efficacy and revealed the beneficial effects of vaginal laser treatment . Currently, there are promising data regarding improvement in subjective symptoms of GSM, vaginal health and flora, sexual function and dyspareunia, and urinary incontinence .…”

“…Several clinical studies have investigated the efficacy and revealed the beneficial effects of vaginal laser treatment . Currently, there are promising data regarding improvement in subjective symptoms of GSM, vaginal health and flora, sexual function and dyspareunia, and urinary incontinence . Prior publications revealed that vaginal cytology had improved significantly, reflected by an increase in the vaginal maturation values (VMV) after vaginal laser treatment in postmenopausal women with GSM .…”