IMR Press / CEOG / Volume 49 / Issue 9 / DOI: 10.31083/j.ceog4909212
Open Access Original Research
The Efficacy of Fractional CO2 Laser in the Treatment of Genitourinary Syndrome of Menopause: A Large Prospective Observational Study
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1 Department of Maternal and Child Health and Urological Sciences, Sapienza University, Umberto I Hospital, 00161 Rome, Italy
2 Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology'', Sapienza University, 00185 Rome, Italy
*Correspondence: ottavia.doria@uniroma1.it (Ottavia D'Oria)
These authors contributed equally.
Academic Editors: Panagiotis Anagnostis and Shigeki Matsubara
Clin. Exp. Obstet. Gynecol. 2022, 49(9), 212; https://doi.org/10.31083/j.ceog4909212
Submitted: 24 June 2022 | Revised: 10 August 2022 | Accepted: 10 August 2022 | Published: 7 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Genitourinary syndrome of menopause (GSM) majorly caused by the physiological decline in estrogen, affects up to 90% of menopausal women. Hormonal therapy seems to be an effective treatment, often not executable for contraindication or patient’s low compliance to local or systemic medical therapy. Fractional CO2 laser therapy is an emerging and effective choice for women affected by vulvo-vaginal atrophy (VVA), promoting collagen regeneration and improving blood flow of the vaginal mucosa and elasticity of tissues. Methods: Ninety-two menopausal Patients affected by vulvo-vaginal atrophy (VVA) were considered for the present prospective observational study. All women were treated with Fractional CO2 laser Lumenis AcuPulse in a fractionated sequential mode laser pulse. Patients were requested to complete questionnaires regarding the Female Sexual Functional Index (FSFI), Female Sexual Distress Scale (FSDS) and severity of Most Bothersome Symptoms (MBS) at baseline (T0) and at three-month following three-treatment-sessions (T1). Results: Data indicated a significant improvement of MBS (vaginal itching (p < 0.0001), post-coital vaginal bleeding (p < 0.002), vaginal dryness (p < 0.0001), dyspareunia (p < 0.0001) and dysuria (p < 0.0001), higher Vaginal Health Index Score (VHIS) (4.1 ± 1.21; 95% CI = 3.84–4.35) and reduces pH (–0.53 ± 0.24; 95% CI = 0.48–0.58) after CO2 laser treatment. A significantly improvement of FSFI Total score (p < 0.0001) and FSDS (p < 0.0001) have been demonstrated. Conclusions: Fractional CO2 laser improves vaginal health as well as signs and symptoms associated with GSM, while significantly elevating quality of life and sexual functionality among postmenopausal symptomatic women.

Keywords
vulvovaginal atrophy
fractional CO2 laser
menopause
laser safety
genitourinary syndrome
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