Vaginal Fractional Carbon Dioxide Laser Treatment and Changes in Vaginal Biomechanical Parameters

Abstract

Background and Objectives: Vaginal fractional carbon dioxide (CO 2 ) laser treatment has emerged in the past two decades as a non-surgical option for vaginal tightening. Mounting evidence supports the effectiveness and safety of this treatment for female sexual dysfunction. A newly developed vaginal tactile imaging (VTI) technique accurately evaluates the biomechanical parameters of the female pelvic floor and vagina, including tissue elasticity, pelvic support, and pelvic muscle function in high definition. In the current study, we evaluated changes in objective biomechanical parameters using VTI, following vaginal CO 2 laser treatment for vaginal tightening and sexual dysfunction. Study Design/Materials and Methods: We conducted a prospective cohort between June 2018 and January 2020. Inclusion criteria were vaginal looseness, decreased local sensation during sexual intercourse, and sexual dysfunction. All the participants were treated with a vaginal carbon dioxide laser. They underwent a gynecological evaluation based on the Vaginal Health Index (VHI) and sexual function assessment according to the Female Sexual Function Index (FSFI). Vaginal biomechanical parameters were assessed by VTI. Initial evaluations were performed at the pre-treatment consult visit, 1 week prior to the first treatment and at a 6-month post-treatment follow-up visit. Results: Twenty-five women were included in the final analysis. Compared with baseline, the post-treatment mean scores for vaginal elasticity and tightening were higher (54.8 ± 5.2 vs. 41.5 ± 6.3, P = 0.0027 and 1.97 ± 0.25 vs. 1.32 ± 0.31, P = 0.0014, respectively). Post-treatment increases were demonstrated in pelvic muscle contraction strength (25.9 ± 3.5 vs. 16.5 ± 4.2, P = 0.0011) and in reflex pelvic muscle contraction (2.93 ± 0.44 vs. 2.12 ± 0.47,

Fractional carbon dioxide vaginal laser treatment of stress urinary incontinence: Remodeling of vaginal tissues and improving pelvic floor structures

“…In the current study, we used VTI, a technology that provides accurate and objective evaluation of vaginal biophysical parameters, 30,39 to assess biomechanical changes in vaginal tissues after treatment. VTI evaluation confirmed that fractional CO 2 laser treatment improves many biomechanical properties of vaginal tissue, including vaginal elasticity and tightening, the contraction strength of pelvic muscles, and the reflex of pelvic muscle contraction 39 .…”

“…In the current study, we used VTI, a technology that provides accurate and objective evaluation of vaginal biophysical parameters, 30,39 to assess biomechanical changes in vaginal tissues after treatment. VTI evaluation confirmed that fractional CO 2 laser treatment improves many biomechanical properties of vaginal tissue, including vaginal elasticity and tightening, the contraction strength of pelvic muscles, and the reflex of pelvic muscle contraction 39 . Using VTI, we showed the benefits of vaginal fractional CO 2 laser treatment in tightening the tissue of the vaginal wall, consistent with the report by Lauterbach et al 39 These data together demonstrate that VTI renders an objective and quantitative assessment to guide physicians in the use of energy‐based therapies.…”

Fractional Carbon Dioxide Laser Improves Vaginal Laxity via Remodeling of Vaginal Tissues in Asian Women

“…Our study aimed to overcome this limitation by adding an objective approach such as VTI for a more comprehensive evaluation of treatment efficacy. VTI technology can reveal fine biomechanical changes in vaginal tissues after treatment [ 18 , 21 ]. Lauterbach et al showed improvement in four biomechanical parameters of vaginal tissue after fractional CO 2 laser treatment, including vaginal elasticity, tightening, contraction strength of pelvic muscles, and reflex of pelvic muscle contraction [ 21 ].…”

“…VTI technology can reveal fine biomechanical changes in vaginal tissues after treatment [ 18 , 21 ]. Lauterbach et al showed improvement in four biomechanical parameters of vaginal tissue after fractional CO 2 laser treatment, including vaginal elasticity, tightening, contraction strength of pelvic muscles, and reflex of pelvic muscle contraction [ 21 ]. We have demonstrated the restoration of vaginal tightening at both the anterior and posterior vaginal walls using VTI, which is consistent with the report by Lauterbach et al [ 21 ].…”

“…Lauterbach et al showed improvement in four biomechanical parameters of vaginal tissue after fractional CO 2 laser treatment, including vaginal elasticity, tightening, contraction strength of pelvic muscles, and reflex of pelvic muscle contraction [ 21 ]. We have demonstrated the restoration of vaginal tightening at both the anterior and posterior vaginal walls using VTI, which is consistent with the report by Lauterbach et al [ 21 ]. These data together demonstrate that VTI provides an objective and quantitative assessment to guide physicians in the use of energy-based therapies.…”