Athanasiou S, Pitsouni E, Antonopoulou S, Zacharakis D, Salvatore S, Falagas M E, Grigoriadis T
a Urogynecology Unit, 1st Department of Obstetrics and Gynecology , "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece ;
b Alpha Institute of Biomedical Sciences (AIBS) , Athens , Greece ;
Climacteric. 2016 Oct;19(5):512-8. doi: 10.1080/13697137.2016.1212006. Epub 2016 Aug 24.
To assess the effect of microablative fractional CO2 laser (MFCO2-Laser) therapy on the vaginal microenvironment of postmenopausal women.
Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear <5%. Vaginal fluid pH values, fresh wet mount microscopy, Gram stain and aerobic and anaerobic cultures were evaluated at baseline and 1 month after each subsequent therapy. Nugent score and Hay-Ison criteria were used to evaluate vaginal flora.
Fifty-three women (mean age 57.2 ± 5.4 years) participated and completed this study. MFCO2-Laser therapy increased Lactobacillus (p < 0.001) and normal flora (p < 0.001) after the completion of the therapeutic protocol, which decreased vaginal pH from a mean of 5.5 ± 0.8 (initial value) to 4.7 ± 0.5 (p < 0.001). The prevalence of Lactobacillus changed from 30% initially to 79% after the last treatment. Clinical signs and symptoms of bacterial vaginosis, aerobic vaginitis or candidiasis did not appear in any participant.
MFCO2-Laser therapy is a promising treatment for improving the vaginal health of postmenopausal women by helping repopulate the vagina with normally existing Lactobacillus species and reconstituting the normal flora to premenopausal status.
评估微剥脱性分次二氧化碳激光（MFCO2-Laser）治疗对绝经后女性阴道微环境的影响。
对有中度至重度绝经泌尿生殖综合征症状、阴道液pH值>4.5且阴道涂片表层上皮细胞<5%的绝经后女性，每月进行一次，共三次激光治疗。在基线时以及每次后续治疗后1个月，评估阴道液pH值、新鲜湿片显微镜检查、革兰氏染色以及需氧和厌氧培养。采用 Nugent 评分和 Hay-Ison 标准评估阴道菌群。
53名女性（平均年龄57.2±5.4岁）参与并完成了本研究。MFCO2-Laser治疗完成后，乳酸杆菌（p<0.001）和正常菌群（p<0.001）增加，阴道pH值从平均5.5±0.8（初始值）降至4.7±0.5（p<0.001）。乳酸杆菌的患病率从最初的30%变为最后一次治疗后的79%。任何参与者均未出现细菌性阴道病、需氧性阴道炎或念珠菌病的临床体征和症状。
MFCO2-Laser治疗通过帮助阴道重新定植正常存在的乳酸杆菌物种并将正常菌群恢复到绝经前状态，是改善绝经后女性阴道健康的一种有前景的治疗方法。
