title: Fractional CO2 laser for vulvovaginal atrophy (VVA) dyspareunia relief in breast cancer survivors.
abstract: The aim of this study was to evaluate the efficacy of fractional CO2 laser therapy in breast cancer survivors as a therapeutic method for vulvovaginal atrophy (VVA) dyspareunia.
  
  
  
  50 patients (mean age 53.3 years) underwent fractional microablative CO2 laser treatment for dyspareunia in oncological menopause (mean time of menopause 6.6 years). The Gloria Bachmann's Vaginal Health Index (VHI) score was chosen as system to evaluate the presence of VVA and its improvement after the treatment. Intensity of dyspareunia was evaluated using a visual analog scale (VAS).
  
  
  
  Data indicated a significant improvement in VVA dyspareunia (p < 1.86e-22) in breast cancer survivors who had undergone 3 sessions of vaginal fractional CO2 laser treatment. Moreover, VHI scores were significantly higher 30 days post-treatment (T4) (p < 0.0001). 76 % of patients were satisfied or very satisfied with the treatment results. The majority (52 %) of patients were satisfied after a long-term follow-up (mean time 11 months). No adverse events due to fractional CO2 laser treatment occurred.
  
  
  
  The treatment with fractionated CO2 laser appeared to be a feasible and effective treatment for VVA dyspareunia in breast cancer survivors with contraindications to hormonal treatments.
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy. clabianchi85@gmail.com.|, Largo Brambilla 3, 50134, Florence, Italy. clabianchi85@gmail.com.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pieralli
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Fallani
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Angelamaria
authors.initials: A
authors.lastname: Becorpi
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bianchi
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Corioni
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Longinotti
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Zelinda
authors.initials: Z
authors.lastname: Tredici
authors.affiliation: Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy.
authors.forename: Secondo
authors.initials: S
authors.lastname: Guaschino
mesh_terms: D001284:Atrophy; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology; D004414:Dyspareunia / Q000628:therapy*; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome; D014621:Vagina / Q000473:pathology*; D014844:Vulva / Q000473:pathology*
keywords: Breast cancer survivors; Laser; Oncological menopause; Vulvovaginal atrophy