Sokol Eric R, Karram Mickey M
1Division of Urogynecology and Pelvic Reconstructive Surgery, Stanford University, Stanford, CA 2Advanced Urogynecology and Pelvic Surgery, The Christ Hospital, Cincinnati, OH.
Menopause. 2016 Oct;23(10):1102-7. doi: 10.1097/GME.0000000000000700.
The aim of the study was to assess the safety and efficacy of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause (GSM).
Women presenting with GSM and meeting study criteria were enrolled. Examinations at baseline and follow-up (3 mo after final treatment) evaluated dilator tolerance and vaginal pH. Visual analog scales were used to assess pain, vaginal burning, vaginal itching, vaginal dryness, dyspareunia, and dysuria; Vaginal Health Index scores were completed before each treatment and at follow-up; Female Sexual Function Index and Short Form 12 questionnaires were also completed. Participant satisfaction was measured on a 5-point Likert scale (1 = very dissatisfied, 5 = very satisfied). Women received three laser treatments, 6 weeks apart.
Thirty women participated (mean age 58.6 ± 8.8 y). None withdrew or were discontinued due to an adverse event; three were lost to follow-up. Average improvement in visual analog scale scoring was 1.7 ± 3.2 for pain, 1.4 ± 2.9 for burning, 1.4 ± 1.9 for itching, 6.1 ± 2.7 for dryness, 5.1 ± 3.0 for dyspareunia, and 1.0 ± 2.4 for dysuria; improvement in average Vaginal Health Index and Female Sexual Function Index scores were statistically significant (P < 0.001). Twenty-five of 30 participants (83%) showed increase in comfortable dilator size at 3-month follow up. Before the second and third treatments, 86.6% (26 of 30) of women reported they were better or much better than at the previous treatment; 26 of 27 women (96%) were reportedly satisfied or extremely satisfied at follow-up.
In this sample, the data suggest that the fractional CO2 laser is effective and safe for treatment of the symptoms associated with GSM.
本研究旨在评估一种新型二氧化碳点阵激光治疗绝经后泌尿生殖综合征（GSM）的安全性和有效性。
招募出现GSM且符合研究标准的女性。在基线和随访时（最后一次治疗后3个月）进行检查，评估扩张器耐受性和阴道pH值。使用视觉模拟量表评估疼痛、阴道烧灼感、阴道瘙痒、阴道干燥、性交困难和排尿困难；在每次治疗前和随访时完成阴道健康指数评分；还完成了女性性功能指数和简明健康调查问卷。参与者满意度采用5分李克特量表进行测量（1=非常不满意，5=非常满意）。女性接受三次激光治疗，每次间隔6周。
30名女性参与研究（平均年龄58.6±8.8岁）。无人因不良事件退出或中断研究；3人失访。视觉模拟量表评分的平均改善情况为：疼痛1.7±3.2，烧灼感1.4±2.9，瘙痒1.4±1.9，干燥6.1±2.7，性交困难5.1±3.0，排尿困难1.0±2.4；阴道健康指数和女性性功能指数评分的平均改善具有统计学意义（P<0.001）。30名参与者中有25名（83%）在3个月随访时舒适扩张器尺寸增加。在第二次和第三次治疗前，86.6%（30名中的26名）的女性报告她们比上一次治疗时有所改善或改善很多；据报道，27名女性中有26名（96%）在随访时感到满意或极其满意。
在本样本中，数据表明二氧化碳点阵激光治疗与GSM相关症状有效且安全。
