Title : CO2 therapy for vaginal atrophy
Abstract:
Objective: Five patients diagnosed with vaginal atrophy underwent CO2 laser therapy, exhibiting different menopausal statuses. Comprehensive medical history was obtained, including obstetric backgrounds, menopausal status, and recent Pap smear results. Transvaginal ultrasound examinations were performed to assess gynecological health. Additionally, patients completed a detailed questionnaire evaluating vulvovaginal symptoms both before and after treatment. The treatment regimen included three sessions every five weeks, with energy levels adjusted based on menopausal status. The energy utilized during therapy varied, with menopausal patients receiving 70 mJ/pixel, 65 mJ/pixel, and 60 mJ/pixel in successive sessions, while non-menopausal patients received 100 mJ/pixel, 95 mJ/pixel, and 90 mJ/pixel in their respective sessions. Patients also applied a vaginal cream containing hyaluronic acid on alternate days between sessions.
Results: Following CO2 laser therapy, all patients reported significant improvements in vulvovaginal symptoms, including itching, burning, pain, irritation, dryness, and discharge. Moreover, enhancements in sexual function were observed, with patients reporting reduced discomfort during intercourse and increased lubrication. The use of a detailed questionnaire, AVV questionnaire, facilitated a comprehensive evaluation of symptoms and treatment outcomes. By assigning a score from 0 to 3 to each question of the questionnaire (composed of 21 questions)
administered to the patient before and after treatment, a remarkable improvement in vaginal atrophy discomfort was observed. We went from an average score of 56 points pre-treatment to 26 points post-treatment.These improvements were discernible as early as the initial session and persisted throughout the treatment course.
Conclusions: CO2 laser therapy demonstrates significant efficacy in managing vaginal atrophy associated with GSM. Our findings highlight the substantial relief of symptoms and improvements in sexual function achieved through this minimally invasive intervention. The integration of a detailed questionnaire, including the AVV questionnaire, facilitated comprehensive evaluation of symptoms and treatment outcomes. Despite promising results, further research involving larger cohorts and longer follow-up periods is warranted to validate the enduring efficacy and safety of CO2 laser therapy for GSM. Nevertheless, our findings advocate for the role of laser therapy as a valuable alternative for managing genitourinary symptoms in menopausal women, particularly for
those reluctant or ineligible for hormonal therapy.
Audience Take Away:
- Understand the effectiveness of CO2 therapy in treating vaginal atrophy.
- Learn about the potential benefits and limitations of CO2 laser therapy.
- Gain insights into the application of CO2 therapy in clinical practice for managing vaginal atrophy.
