Abstract

SIMOES, Mafalda Martinho; TELHADO, Conceição  and  FRAGA, Teresa. Fractional CO2 laser treatment for vulvovaginal atrophy. Acta Obstet Ginecol Port [online]. 2018, vol.12, n.3, pp.176-180. ISSN 1646-5830.

Overview: Fractional CO2 laser treatment for vulvovaginal atrophy (VVA) is a ground-breaking treatment according to recent studies. Although local estrogens are considered the first line treatment for severe VVA in postmenopausal women, a significant proportion of patients do not respond, do not adhere or have contraindications to hormonal treatments. In these situations, fractional CO2 laser may represent a good alternative. Aims: To analyze the efficacy and safety of fractional CO2 laser treatment for VVA. Study design: Retrospective observational study Population: 27 postmenopausal women treated for VVA with 2 or 3 sessions of fractional microablative CO2 laser system. Methods: We inquired patients about VVA symptoms (vaginal dryness, dyspareunia, vaginal burning, postcoital bleeding and urinary symptoms) before and after the treatment and a scale of 0-4 was used. Overall satisfaction was classified with a 5-point Likert scale. All patients had a previous colposcopic evaluation, which revealed VVA and a repeat colposcopy was performed after the treatment. Data were analyzed with SPSS® V24. Results: Mean age was 57.7 years ± 4.5 years old and 11% (3 women) had a background of breast cancer. We obtained a significant improvement in all VVA symptoms except for urinary symptoms. Mean overall satisfaction was 4.0 ± 0.92, with only one patient very dissatisfied with the treatment due to a persistent vulvodynia. Follow up colposcopy showed absence of vaginal atrophy signs in all women. No complications were reported and the treatment was painless in all cases, with no need of any kind of anesthesia. Conclusions: This study suggests that this new treatment modality is safe and effective in the treatment of VVA and may be considered for women with severe VVA who do not respond or have contraindications to hormonal therapy. However the duration of therapeutic effects is not clear and further research is needed.

Keywords : Vulvovaginal atrophy; CO2 laser; Genitourinary syndrome of menopause.

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