Microablative fractional CO2-laser therapy and the genitourinary syndrome of menopause: An observational study.
OBJECTIVE
This study aimed to assess the effect of the Microablative Fractional CO2Laser (CO2-laser) therapy on vaginal pathophysiology and the symptoms of the Genitourinary Syndrome of Menopause (GSM).


METHODS
Postmenopausal women with moderate to severe symptoms of GSM underwent three sessions of CO2-laser therapy at monthly intervals. Participants were evaluated at baseline and 4 weeks after the last treatment.


METHODS
The primary outcomes were Vaginal Maturation Value (VMV) and Vaginal Health Index Score (VHIS). Secondary outcomes included symptoms of GSM, Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire of Female Urinary Tract Symptoms (ICIQ-FLUTS) and Urinary Incontinence Short Form (ICIQ-UI SF), Urogenital Distress Inventory (UDI-6) and King's Health Questionnaire (KHQ).


RESULTS
Fifty-three postmenopausal women completed this study. VMV, VHIS and FSFI increased significantly. Dyspareunia, dryness, burning, itching, dysuria, frequency, urgency, urgency incontinence, stress incontinence and scores on the ICIQ-FLUTS, ICIQ-UI SF, UDI-6 and KHQ decreased significantly. Factors predicting for which women the CO2-laser therapy was more effective were not identified.


CONCLUSIONS
This study suggests that intravaginal CO2-laser therapy for postmenopausal women with clinical signs and symptoms of GSM may be effective in improving both vaginal pathophysiology and reported symptoms.
Urogynecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Eleni
E
Pitsouni
Urogynecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Themos
T
Grigoriadis
Cytology Department, "Alexandra Hospital", Athens, Greece.
Angeliki
A
Tsiveleka
Urogynecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Dimitris
D
Zacharakis
Obstetrics and Gynecology Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Urogynecology Unit, Milan, Italy.
Stefano
S
Salvatore
Urogynecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: athanasio@otenet.gr.
Stavros
S
Athanasiou
D004414:Dyspareunia / Q000601:surgery*; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008593:Menopause; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013577:Syndrome; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
Dyspareunia; Menopause; Sexual function; Urgency; Urinary incontinence; Vulvovaginal atrophy