Vaginal laser therapy versus hyaluronic acid suppositories for women with symptoms of urogenital atrophy after treatment for breast cancer: A randomized controlled trial

Gold, Daniela; Nicolay, Laura; Avian, Alexander; Greimel, Elfriede; Balić, Marija; Pristauz-Telsnigg, Gunda; Tamussino, Karl; Trutnovsky, Gerda

doi:10.1016/j.maturitas.2022.08.013

Cited by 15 publications

(23 citation statements)

References 29 publications

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“… 52 At 12 weeks follow-up, there was a significant improvement in VHI in both arms, without any difference between erbium laser and hyaluronic acid. 52 Moreover, bother related to symptoms of urogenital atrophy, dyspareunia and urgency appeared significantly reduced after both interventions, whereas stress urinary incontinence was significantly less bothersome only following laser treatment. 51 Several domains of QoL were improved in both treatment arms, while sexual satisfaction and other domains of sexual function did not change, with the exception of sexual pain which improved only following laser treatment.…”

Section: Resultsmentioning

confidence: 82%

“… 39 That being so, we calculated that 789 BCSs were included in the studies: 731 of them were treated with vaginal laser (626 with micro ablative CO 2 laser, 105 with non-ablative erbium laser) 33–52 and 21 participants received local hyaluronic acid treatment as control arm. 52 …”

Section: Resultsmentioning

confidence: 99%

“…Retrospective studies were also common, while a comparison with local hyaluronic acid was reported only in one randomized trial with erbium laser. 52 Our search identified only one double-blinded randomized sham-controlled trial in the BCSs population. 48 Results reported in individual studies are displayed in Table 1 for fractional micro ablative CO 2 laser and in Table 2 for erbium laser.…”

Section: Resultsmentioning

confidence: 99%

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Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Cucinella¹,

Tiranini²,

Cassani³

et al. 2023

IJWH

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Genitourinary syndrome of menopause (GSM) is a frequent consequence of iatrogenic menopause or anti-estrogenic adjuvant therapies in breast cancer survivors (BCSs). GSM may profoundly affect sexual health and quality of life, and a multidimensional unique model of care is needed to address the burden of this chronic heterogeneous condition. Severe symptoms may be insufficiently managed with non-hormonal traditional treatments, such as moisturizers and lubricants, recommended as the first-line approach by current guidelines, because concerns exist around the use of vaginal estrogens, particularly in women on aromatase inhibitors (AIs). Vaginal laser therapy has emerged as a promising alternative in women with GSM who are not suitable or do not respond to hormonal management, or are not willing to use pharmacological strategies. We aim to systematically review current evidence about vaginal laser efficacy and safety in BCSs and to highlight gaps in the literature. We analyzed results from 20 studies, including over 700 BCSs treated with either CO 2 or erbium laser, with quite heterogeneous primary outcomes and duration of follow up (4 weeks–24 months). Although evidence for laser efficacy in BCSs comes mostly from single-arm prospective studies, with only one randomized double-blind sham-controlled trial for CO 2 laser and one randomized comparative trial of erbium laser and hyaluronic acid, available data are reassuring in the short term and indicate effectiveness of both CO 2 and erbium lasers on the most common GSM symptoms. However, further studies are mandatory to establish long-term efficacy and safety in menopausal women, including BCSs.

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Section: Resultsmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Cucinella¹,

Tiranini²,

Cassani³

et al. 2023

IJWH

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“…These were analyzed for 3 months on a group of 43 patients treated with Erbium laser or local hyaluronic acid. Both treatments were effective for patients with previous breast cancer [76]. Even if the effectiveness of vaginal lasers using both CO 2 and Erbium is confirmed in most studies, there are no studies that demonstrate their real long-term effectiveness.…”

Section: Discussionmentioning

confidence: 96%

Therapeutic Choices for Genitourinary Syndrome of Menopause (GSM) in Breast Cancer Survivors: A Systematic Review and Update

Merlino¹,

D’Ovidio²,

Piccioni³

et al. 2023

Pharmaceuticals

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(1) Background: Genitourinary syndrome of menopause (GSM) is a medical condition that can affect breast cancer survivors (BCS). This is a complication that often can occur as a result of breast cancer treatment, causing symptoms such as vaginal dryness, itching, burning, dyspareunia, dysuria, pain, discomfort, and impairment of sexual function. BCS who experience these symptoms negatively impact multiple aspects of their quality of life to the point that some of them fail to complete adjuvant hormonal treatment; (2) Methods: In this systematic review of the literature, we have analyzed possible pharmacological and non-pharmacological treatments for GSM in BCS. We reviewed systemic hormone therapy, local hormone treatment with estrogens and androgens, the use of vaginal moisturizers and lubricants, ospemifene, and physical therapies such as radiofrequency, electroporation, and vaginal laser; (3) Results: The data available to date demonstrate that the aforementioned treatments are effective for the therapy of GSM and, in particular, vulvovaginal atrophy in BCS. Where possible, combination therapy often appears more useful than using a single line of treatment; (4) Conclusions: We analyzed the efficacy and safety data of each of these options for the treatment of GSM in BCS, emphasizing how often larger clinical trials with longer follow-ups are needed.

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“…There are several studies comparing CO 2 or Yag laser therapy to traditional treatments, and one that is a sham-controlled trial of laser. When comparing laser to vaginal estrogen to intravaginal hyaluronic acid moisturizers in a randomized setting, all seem to have the same benefit on measures of objective vaginal maturation as well as on symptom relief for women [4]. When CO 2 laser was compared to sham laser, it did not perform better than sham; however, this study enrolled a high proportion of women being treated for breast cancer with aromatase inhibitors, which can negatively affect the vaginal mucosa [5 & ].…”

Section: Genitourinary Syndrome Of Menopausementioning

confidence: 99%

Complex vulvar and vaginal disease in menopause

Fuller

Dunsmoor-Su

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewMenopause is a time of vulvar and vaginal changes that are physiologic and are often symptomatic. These changes can impact up to 50% of women in menopause. There are also several vulvar dermatoses that are more common after menopause and should be recognized early to allow for symptomatic treatment. Some of these conditions can lead to squamous cell carcinoma over time, and early recognition and appropriate treatment reduce this risk. Treatment for women with symptomatic vulvar and vaginal conditions is important for maintaining the quality of life. Recent findingsThere are multiple review articles, small case series, and small comparative trials, but definitive trials are unavailable for most of these conditions. SummaryCurrent research on pathophysiology and treatment is limited to all of these conditions, and more focus on these life-altering conditions is warranted.

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Vaginal laser therapy versus hyaluronic acid suppositories for women with symptoms of urogenital atrophy after treatment for breast cancer: A randomized controlled trial

Cited by 15 publications

References 29 publications

Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Therapeutic Choices for Genitourinary Syndrome of Menopause (GSM) in Breast Cancer Survivors: A Systematic Review and Update

Complex vulvar and vaginal disease in menopause

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