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The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study.
Lasers Surg Med. 2021 07; 53(5):647-653.LS

Abstract

BACKGROUND AND OBJECTIVES

Genitourinary syndrome of menopause (GSM) is a common condition affecting of most postmenopausal women, which greatly impacks the quality of life,and need to treat. This prospective multicenter cohort study aimed to compare the efficacy and safety of the fractional carbon dioxide (CO2) laser with that of topical estrogen for vaginal treatment and relieving symptoms of genitourinary syndrome of menopause (GSM).

STUDY DESIGN/MATERIALS AND METHODS

This study included 162 postmenopausal patients who received vaginal laser or topical Estriol cream therapy between January 2017 and May 2019 at eight study centers in China. The degree of GSM-related symptoms (vaginal burning, dryness, and dyspareunia) was evaluated using the Vaginal Health Index score (VHIS) and Visual Analog Scale (VAS) at baseline, 1, 3, 6, and 12 months posttreatment. The primary endpoint was the improvement in vaginal burning, dryness, and dyspareunia at 6 months after treatment. Multivariate logistic regression was used to compare the rate of improvement in the two groups.

RESULTS

At baseline, the laser and control groups showed no significant difference in the mean age, time after menopause, and the VHIS (all P > 0.05). In the laser group, compared with baseline, significant differences were seen in the VHIS after the first or second treatment session and at 1, 3, 6, and 12 months posttreatment (P < 0.01). In the control group, compared with baseline, the VHIS showed significant differences after 1, 3, and 6 months of treatment (P < 0.05). However, there was no significant difference after 3 and 6 months of follow-up between the two groups (P > 0.05). The VHIS scores were significantly higher after 1 month (16.63 ± 2.79 vs. 15.57 ± 2.43) and 12 months (15.72 ± 2.59 vs. 12.12 ± 4.08) of treatment in both the groups (P < 0.05). At 6 months after treatment, both groups showed improvement in vaginal burning, vaginal dryness, and dyspareunia (P > 0.05). The VAS findings at 6 months posttreatment were significantly different when compared with the pretreatment findings (P < 0.001). There were no significant adverse effects in the two groups.

CONCLUSIONS

Fractional CO2 laser vaginal treatment could be a safe and effective option for treating symptoms of GSM, including vaginal burning, dryness, and dyspareunia. The improvement in symptoms was comparable with that seen with topical estrogen therapy and lasted for at least 6-12 months posttreatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Peking University People's Hospital, Xizhimen, South Street, Beijing, Beijing, 100044, China.Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Lianhua Road, Shenzhen, Guangdong, 518036, China.Department of Obstetrics and Gynecology, Changsha Hospital for Maternity and Child Healthcare, Chengnan East Road, Changsha, Hunan, 410007, China.Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Yanjiang West Road, Guangzhou, Guangdong, 510120, China.Department of Obstetrics and Gynecology, West China Second University Hospital, Renmin South Road, Chengdu, Sichuan, 610041, China.Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Kangfuqian Street, Zhengzhou, Henan, 450008, China.Department of Obstetrics and Gynecology, Puyang Oilfield General Hospital, Daqing Road, Puyang, Henan, 457000, China.Department of Obstetrics and Gynecology, Liuzhou Maternity and Child Healthcare Hospital, Sanzhong Road, Liuzhou, Guangxi, 545001, China.Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Lianhua Road, Shenzhen, Guangdong, 518036, China.Department of Obstetrics and Gynecology, Changsha Hospital for Maternity and Child Healthcare, Chengnan East Road, Changsha, Hunan, 410007, China.Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Yanjiang West Road, Guangzhou, Guangdong, 510120, China.Department of Obstetrics and Gynecology, Peking University People's Hospital, Xizhimen, South Street, Beijing, Beijing, 100044, China.Department of Obstetrics and Gynecology, Peking University People's Hospital, Xizhimen, South Street, Beijing, Beijing, 100044, China.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33211334

Citation

Li, Jingran, et al. "The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: a Prospective Multicenter Cohort Study." Lasers in Surgery and Medicine, vol. 53, no. 5, 2021, pp. 647-653.
Li J, Li H, Zhou Y, et al. The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study. Lasers Surg Med. 2021;53(5):647-653.
Li, J., Li, H., Zhou, Y., Xie, M., Miao, Y., Wang, L., Zhao, Y., Ying, T., Hu, Y., Chen, Y., Chen, Y., Sun, X., & Wang, J. (2021). The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study. Lasers in Surgery and Medicine, 53(5), 647-653. https://doi.org/10.1002/lsm.23346
Li J, et al. The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: a Prospective Multicenter Cohort Study. Lasers Surg Med. 2021;53(5):647-653. PubMed PMID: 33211334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study. AU - Li,Jingran, AU - Li,Huan, AU - Zhou,Yanfei, AU - Xie,Meiqing, AU - Miao,Yali, AU - Wang,Luwen, AU - Zhao,Yan, AU - Ying,Ting, AU - Hu,Yan, AU - Chen,Yu, AU - Chen,Yaxiao, AU - Sun,Xiuli, AU - Wang,Jianliu, Y1 - 2020/11/19/ PY - 2020/10/10/revised PY - 2020/05/25/received PY - 2020/10/15/accepted PY - 2020/11/20/pubmed PY - 2021/10/29/medline PY - 2020/11/19/entrez KW - fractional CO2 laser KW - genitourinary syndrome of menopause KW - vaginal burning KW - vaginal laser treatment KW - vulvovaginal atrophy SP - 647 EP - 653 JF - Lasers in surgery and medicine JO - Lasers Surg Med VL - 53 IS - 5 N2 - BACKGROUND AND OBJECTIVES: Genitourinary syndrome of menopause (GSM) is a common condition affecting of most postmenopausal women, which greatly impacks the quality of life,and need to treat. This prospective multicenter cohort study aimed to compare the efficacy and safety of the fractional carbon dioxide (CO2) laser with that of topical estrogen for vaginal treatment and relieving symptoms of genitourinary syndrome of menopause (GSM). STUDY DESIGN/MATERIALS AND METHODS: This study included 162 postmenopausal patients who received vaginal laser or topical Estriol cream therapy between January 2017 and May 2019 at eight study centers in China. The degree of GSM-related symptoms (vaginal burning, dryness, and dyspareunia) was evaluated using the Vaginal Health Index score (VHIS) and Visual Analog Scale (VAS) at baseline, 1, 3, 6, and 12 months posttreatment. The primary endpoint was the improvement in vaginal burning, dryness, and dyspareunia at 6 months after treatment. Multivariate logistic regression was used to compare the rate of improvement in the two groups. RESULTS: At baseline, the laser and control groups showed no significant difference in the mean age, time after menopause, and the VHIS (all P > 0.05). In the laser group, compared with baseline, significant differences were seen in the VHIS after the first or second treatment session and at 1, 3, 6, and 12 months posttreatment (P < 0.01). In the control group, compared with baseline, the VHIS showed significant differences after 1, 3, and 6 months of treatment (P < 0.05). However, there was no significant difference after 3 and 6 months of follow-up between the two groups (P > 0.05). The VHIS scores were significantly higher after 1 month (16.63 ± 2.79 vs. 15.57 ± 2.43) and 12 months (15.72 ± 2.59 vs. 12.12 ± 4.08) of treatment in both the groups (P < 0.05). At 6 months after treatment, both groups showed improvement in vaginal burning, vaginal dryness, and dyspareunia (P > 0.05). The VAS findings at 6 months posttreatment were significantly different when compared with the pretreatment findings (P < 0.001). There were no significant adverse effects in the two groups. CONCLUSIONS: Fractional CO2 laser vaginal treatment could be a safe and effective option for treating symptoms of GSM, including vaginal burning, dryness, and dyspareunia. The improvement in symptoms was comparable with that seen with topical estrogen therapy and lasted for at least 6-12 months posttreatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC. SN - 1096-9101 UR - https://www.unboundmedicine.com/medline/citation/33211334/The_Fractional_CO2_Laser_for_the_Treatment_of_Genitourinary_Syndrome_of_Menopause:_A_Prospective_Multicenter_Cohort_Study_ L2 - https://doi.org/10.1002/lsm.23346 DB - PRIME DP - Unbound Medicine ER -