Use of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause: 1-year outcomes.
OBJECTIVE
To assess safety and efficacy of a fractional CO2 laser therapy for the treatment of genitourinary syndrome of menopause (GSM) with follow-up to 1 year posttreatment.


METHODS
Women presenting with GSM and meeting inclusion criterion were enrolled. Visual Analog Scales were used to grade vaginal pain, burning, itching, dryness, dyspareunia, and dysuria. Dilators were used to rate vaginal elasticity at baseline and at each follow-up visit. Before each treatment and at follow-up, Vaginal Health Index scoring and Female Sexual Function Index questionnaires were completed. Women received three vaginal laser treatments spaced 6 weeks apart. Participant satisfaction was measured on 5-point Likert scales (1 = very dissatisfied, 5 = very satisfied).


RESULTS
Of 30 women (mean age 58.6 ± 8.8 years), three were lost to follow-up at 3 months and six at 1 year. None were discontinued or withdrew due to an adverse event. Average improvement in Visual Analog Scale scores for all symptom categories was statistically significant at 3 months and remained so through 1 year, except dysuria. Differences between data at 3 months and 1 year were not statistically significant, indicating persistence of positive outcomes. Average overall improvement in pain was 1.9 (±3.4), burning 1.9 (±3.1), itching 1.4 (±1.9), dryness 5.9 (±2.8), dyspareunia 4.9 (±3.3), and dysuria 0.9 (±3.1). Improvement in average Vaginal Health Index and Female Sexual Function Index scores was also statistically significant (P < 0.0001). Of 19 women undergoing dilator examination at 1 year, 18 (94.8%) were comfortable with the same or larger dilator size. Twenty-two of 24 women (92%) were satisfied or extremely satisfied with the treatment at 1 year.


CONCLUSIONS
Based on study data up to 1 year, the fractional CO2 laser may be an effective and safe treatment for women suffering from symptoms of GSM, although additional studies with larger populations and placebo control is needed to confirm these results.
1Urogynecology and Pelvic Reconstructive Surgery, Stanford University, Stanford, CA 2Advanced Urogynecology and Pelvic Surgery, The Christ Hospital, Cincinnati, OH.
Eric R
ER
Sokol
Mickey M
MM
Karram
D000368:Aged; D004414:Dyspareunia / Q000209:etiology / Q000473:pathology / Q000601:surgery; D053159:Dysuria / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D052776:Female Urogenital Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008593:Menopause; D008875:Middle Aged; D010147:Pain Measurement; D013577:Syndrome; D016896:Treatment Outcome; D014621:Vagina / Q000473:pathology / Q000601:surgery; D014623:Vaginal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery