Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

Abstract

Vulvovaginal atrophy (VVA) is a chronic condition resulting from reduced estrogen levels during menopause. The North American Menopause Society and the International Society for the Study of Women's Sexual Health suggested the term "genitourinary syndrome of menopause" (GSM) to indicate the broader aspects of VVA. Breast cancer treatments, such as chemotherapy and endocrine therapy, can induce early and abrupt menopausal symptoms, including GSM, which negatively affects sexual function and the quality of life of the survivors. Vaginal laser therapy has emerged as a safe and effective option for the management of GSM in breast cancer survivors (BCSs). Two main types of lasers, the non-ablative erbium:YAG laser and fractional microablative CO 2 vaginal laser, have been evaluated for GSM treatment. While there are few randomized controlled trials (RCTs) on the subject of BCSs, a wealth of prospective and retrospective studies have highlighted the beneficial effects of vaginal laser therapy on the symptoms of VVA, vaginal health, sexual function, and overall quality of life. More comprehensive research is essential to confirm its enduring effectiveness and safety, with a focus on conducting standardized and meticulously controlled investigations. This study is a narrative review that summarizes clinical trials ranging from the earliest to the most recent ones on laser treatment for GSM in BCSs.

Non-ablative Erbium (YAG) and Neodymium (YAG) Laser Treatment for Anal Incontinence and Vaginal Atrophy: A Case Study

“…Vaginal Erbium YAG (VEL) and Neodymium YAG (Nd:YAG) laser treatment improved vaginal pain and health index, with concurrent fecal incontinence improvement observed after the first session (L1). This treatment approach is supported by the literature demonstrating the efficacy of Er:YAG and Nd:YAG lasers in managing genitourinary syndrome and rectal prolapse symptoms, respectively [10,14]. This combination is known to promote collagen production and tissue regeneration.…”

“…This emphasizes the importance of identifying alternative treatments, such as laser therapy, for symptoms that are resistant to standard methods. VVA, affecting 75.3 to 87.3% of all women, is common [8,9] and is related to Genitourinary Syndrome of Menopause (GSM) [10], which includes menopausal symptoms, such as vaginal dryness and urinary discomfort, encompassing a broader range of symptoms affecting the genital and urinary systems and driving many gynecological consultations. Additionally, these conditions are often associated with pelvic floor muscle-related diseases, which include conditions affecting pelvic support, such as incontinence and prolapse.…”

“…This case study highlights the potential of laser therapy, underscoring the need for promising alternative means to improve the quality of life (QoL) of patients suffering from AI and VVA, conditions that are often inadequately addressed by conventional treatments [8][9][10][11][12][13][14][15].…”

Navigating Treatment Choices for Stress and Urgency Urinary Incontinence Using Graph Theory in Discrete Mathematics

“…In contrast, laser treatment has been reported to be safe with fewer side effects, and there is evidence of its efficacy in randomized controlled trials) [16,17]. However, even with VEL, the effects last only a few years, necessitating regular treatment [18,19]. Our approach, by considering the history and symptoms of individual patients, has the potential to bridge this gap and enhance the effectiveness of the selected treatment.…”

Pathological Insights on Polypropylene Mesh Complications From Laparoscopic Sacrocolpopexy: A Case Series

“…Previous studies have established the efficacy of AEL, VEL, and Nd:YAG laser treatments for vaginal atrophy (VVA) and anal incontinence (AI) in postmenopausal women [27,40]. These laser treatments improve insufficient blood flow in pelvic vessels through a process known as "re-canalization."…”