title: Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser.
abstract: OBJECTIVE
  To evaluate the efficacy and feasibility of thermo-ablative fractional CO2 laser for the treatment of symptoms related to vulvo-vaginal atrophy (VVA) in post-menopausal women.
  
  
  METHODS
  From April 2013 to December 2013, post-menopausal patients who complained of one or more VVA-related symptoms and who underwent vaginal treatment with fractional CO2 laser were enrolled in the study. At baseline (T0) and 30 days post-treatment (T1), vaginal status of the women was evaluated using the Vaginal Health Index (VHI), and subjective intensity of VVA symptoms was evaluated using a visual analog scale (VAS). At T1, treatment satisfaction was evaluated using a 5-point Likert scale.
  
  
  RESULTS
  During the study period, a total of 48 patients were enrolled. Data indicated a significant improvement in VVA symptoms (vaginal dryness, burning, itching and dyspareunia) (P<0.0001) in patients who had undergone 3 sessions of vaginal fractional CO2 laser treatment. Moreover, VHI scores were significantly higher at T1 (P<0.0001). Overall, 91.7% of patients were satisfied or very satisfied with the procedure and experienced considerable improvement in quality of life (QoL). No adverse events due to fractional CO2 laser treatment occurred.
  
  
  CONCLUSIONS
  Thermo-ablative fractional CO2 laser could be a safe, effective and feasible option for the treatment of VVA symptoms in post-menopausal women.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Perino
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Unit of Histology and Embryology University of Pavia, Pavia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Calligaro
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy. Electronic address: forlani81@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Forlani
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tiberio
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Cucinella
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Svelato
authors.affiliation: Department of Human Pathology, School and Division of Allergy and Clinical Immunology, University of Messina, Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Saitta
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Calagna
mesh_terms: D000282:Administration, Intravaginal; D001284:Atrophy / Q000628:therapy; D004414:Dyspareunia / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D017698:Postmenopause; D011788:Quality of Life; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000601:surgery*; D014844:Vulva / Q000473:pathology*
keywords: Laser treatment; Menopause; Vulvo-vaginal atrophy