Evaluation of the CO<sub>2</sub> Laser Therapy on Vulvo-Vaginal Atrophy (VVA) in Oncological Patients: Preliminary Results
- 1 Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy
- 2 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR)-LATO, Cefalù (PA), Italy
- 3 Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy
- 4 Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy
- 5 Pathology Unit, Cannizzaro Hospital, Catania, Italy
- 6 Pathology Unit, Cannizzaro Hospital, Catania, Italy
- 7 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR)-LATO, Cefalù (PA), Italy
- 8 Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy
- 9 Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania, Italy
Abstract
Objective: To evaluate the impact of fractionated CO2 laser therapy on vaginal atrophy and mild/moderate stress urinary incontinence (SUI) symptoms in patients with physiological or surgically-induced menopause. Materials and Methods: Post-menopausal patients (n = 33) presenting vaginal atrophy and/or SUI, underwent three vaginal CO 2 laser treatment sessions, performed at 1-month intervals. Vaginal symptoms were evaluated using the Vaginal Health Index Score (VHI-S), Visual Analogue Scales (VAS) for dyspareunia and global patient satisfaction. The impact of urinary incontinence on patient quality of life was evaluated using the International Consultation on Incontinence Questionnaire (ICIQ). Symptoms were evaluated before treatment and at every subsequent treatment session, as well as 3 months following the last treatment session. RESULTS: The three-session treatment series led to a significant improvement in both subjective symptoms (dryness, burning, dyspareunia) and clinical signs (VHI-S) (P < 0.01). In addition, reductions in the frequency and severity of SUI symptoms (P < 0.01) were noted during the treatment period, and were maintained after for at least 3 months after completion of the treatment course. Improvements in VHI-S were significantly greater in patients with surgically-induced menopause, as compared to those with physiological menopause. The vast majority of patients (90%) were satisfied with the procedure, and reported a significant improvement in quality of life. No adverse events were recorded throughout the study period. C onclusions: Fractionated CO 2 laser therapy is a safe, effective and easy-to-perform treatment modality for menopause-related vaginal atrophy and SUI.
- (2013) Management of Symptomatic Vulvovaginal Atrophy: 2013 Position Statement of The North American Menopause Society. Menopause, 20, 888-902; quiz 3-4.
- Portman, D.J. and Gass, M.L. (2014) Genitourinary Syndrome of Menopause: New Terminology for Vulvovaginal Atrophy from the International Society for the Study of Women’s Sexual Health and The North American Menopause Society. Climacteric, 17, 557-563. https://doi.org/10.3109/13697137.2014.946279
- Sturdee, D.W. and Panay, N. (2010) Recommendations for the Management of Postmenopausal Vaginal Atrophy. Climacteric, 13, 509-522. https://doi.org/10.3109/13697137.2010.522875
- Iosif, C.S., Batra, S., Ek, A. and Astedt, B. (1981) Estrogen Receptors in the Human Female Lower Uninary Tract. American Journal of Obstetrics and Gynecology, 141, 817-820. https://doi.org/10.1016/0002-9378(81)90710-9
- Fadare, O. (2011) Vaginal Stromal Sclerosis: A Distinctive Stromal Change Associated with Vaginal Atrophy. International Journal of Gynecological Pathology, 30, 295-300.
- Nappi, R.E. and Kokot-Kierepa, M. (2010) Women’s Voices in the Menopause: Results from an International Survey on Vaginal Atrophy. Maturitas, 67, 233-238.
- Nappi, R.E. and Kokot-Kierepa, M. (2012) Vaginal Health: Insights, Views & Attitudes (VIVA)—Results from an International Survey. Climacteric, 15, 36-44. https://doi.org/10.3109/13697137.2011.647840
- Johnston, S.L., Farrell, S.A., Bouchard, C., et al. (2004) The Detection and Management of Vaginal Atrophy. Journal of Obstetrics and Gynaecology Canada, 26, 503-515.
- de Villiers, T.J., Pines, A., Panay, N., et al. (2013) Updated 2013 International Menopause Society Recommendations on Menopausal Hormone Therapy and Preventive Strategies for Midlife Health. Climacteric, 16, 316-337. https://doi.org/10.3109/13697137.2013.795683
- Ronconi, L. and Galli, M. (2012) MonaLisa Touch TM . In: DEKA, Ed., The Latest Frontier in the Treatment of Vaginal Atrophy, Vol. 2, Scientific Series, September.
- Kaufmann, R. and Hibst, R. (1996) Pulsed Erbium:YAG Laser Ablation in Cutaneous Surgery. Lasers in Surgery and Medicine, 19, 324-330. https://doi.org/10.1002/(SICI)1096-9101(1996)19:3 3.0.CO;2-U
- Capon, A. and Mordon, S. (2003) Can Thermal Lasers Promote Skin Wound Healing? American Journal of Clinical Dermatology, 4, 1-12. https://doi.org/10.2165/00128071-200304010-00001