Pieralli Annalisa, Bianchi Claudia, Longinotti Manuela, Corioni Serena, Auzzi Noemi, Becorpi Angelamaria, Fallani Maria Grazia, Cariti Giuseppe, Petraglia Felice
Section of Oncological Gynecology, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
Arch Gynecol Obstet. 2017 Nov;296(5):973-978. doi: 10.1007/s00404-017-4504-8. Epub 2017 Sep 2.
The aim of this study was to evaluate long-term effects of the fractional CO laser for the treatment of vulvovaginal atrophy (VVA) symptoms.
Women presenting with VVA symptoms and meeting inclusion criterion were enrolled to fractioned CO laser therapy. Patient's satisfaction was measured on five-point Likert scale at 4 weeks and 6, 12, 18, 24 months after treatment by interview and clinical examination for vaginal livability.
184 patients constituted the final study group: 128 women were spontaneous menopause and 56 were oncological menopause. 117 women were nulliparous and 36 had previous hysterectomy. 95.4% (172/184) of the patients declared that they were satisfied or very satisfied with the procedure at 4 weeks after treatment. At 6 months 92% (170/184) patients were satisfied; at 12 months 72% (118/162) were satisfied; at 18 months 63% (60/94) were satisfied; at 24 months 25% (4/16) of patients answered they were still satisfied. We observed a decline in patient's satisfaction between 18 and 24 months after laser therapy. Data showed that the time interval from onset of menopause was a statistically significant factor (p < 0.05) for treatment satisfaction in oncological group.
Long-term data showed that the improvement of vaginal health may continue up to 24 months after fractional CO laser treatment although between 18 and 24 months benefits decline, and approximately 80% of women decide to start a new treatment cycle of laser applications.
本研究旨在评估分次二氧化碳激光治疗外阴阴道萎缩（VVA）症状的长期效果。
出现VVA症状且符合纳入标准的女性接受分次二氧化碳激光治疗。在治疗后4周以及6、12、18、24个月时，通过访谈和阴道舒适度临床检查，采用五点李克特量表测量患者满意度。
184名患者构成最终研究组：128名女性为自然绝经，56名为肿瘤性绝经。117名女性未生育，36名曾行子宫切除术。95.4%（172/184）的患者表示在治疗后4周对该治疗满意或非常满意。6个月时92%（170/184）的患者满意；12个月时72%（118/162）满意；18个月时63%（60/94）满意；24个月时25%（4/16）的患者回答仍满意。我们观察到激光治疗后18至24个月患者满意度有所下降。数据显示，绝经开始后的时间间隔是肿瘤组治疗满意度的一个具有统计学意义的因素（p<0.05）。
长期数据表明，分次二氧化碳激光治疗后阴道健康状况的改善可能持续至24个月，尽管在18至24个月时益处有所下降，且约80%的女性决定开始新的激光治疗周期。
