Lekskulchai Orawan, Mairaing Karicha, Vinayanuvattikhun Nipattha
J Med Assoc Thai. 2016 Jul;99 Supopl 4:S54-8.
To evaluate the short term efficacy and safety of Fractional CO2 laser for the treatment of vulvovaginal atrophy.
From March 2015 to October 2015, 112 menopausal women were recruited. All women with VVA were treated by using Fractional CO2 laser; power 30 watts, 1-3 stacks with 360° vaginal probe for 3 consecutive times, 4 weeks apart. Before laser treatment, the subjective measurement of VVA symptoms was evaluated by using a questionnaire and the objective measurements were evaluated by using pH paper and VMI. Visual analog pain-score was used to scaling their discomfort during and immediately after each treatment. At 3 months after the last procedure, the subjective and objective measurements were re-assessed. Any short-term and long-term adverse events were recorded. Statistical analysis was performed by using SPSS program with p-value <0.05.
The median of pre-screening VVA symptom score was 4 and the most bothersome symptom was the “feeling of dryness around vulvar”. There was a significant reduction of the score after laser treatment. The average percentage of pretreatment VMI was 34.7±16.1% and at one and three months after complete laser course, it was significantly increased with the mean change of 25.0±12.2% and 34.8±15.5%, respectively. For the vaginal pH, the average pH before treatment was 7.5±1.0 and the average decrement after 3 months was 0.9±1.3 with statistical significance, p-value <0.01. There were no serious complications and all were satisfied with the treatment.
Fractional CO2 laser could ameliorate the VVA symptoms with at least 3 months of long lasting improvement of vaginal health with safety.
评估二氧化碳点阵激光治疗外阴阴道萎缩的短期疗效及安全性。
2015年3月至2015年10月，招募了112名绝经后女性。所有外阴阴道萎缩患者均接受二氧化碳点阵激光治疗；功率30瓦，使用360°阴道探头，1 - 3层，连续治疗3次，每次间隔4周。激光治疗前，通过问卷调查对患者外阴阴道萎缩症状进行主观评估，使用pH试纸和阴道黏膜图像分析（VMI）进行客观评估。采用视觉模拟疼痛评分法评估每次治疗期间及治疗后即刻的不适程度。在最后一次治疗后3个月，重新评估主观和客观指标。记录所有短期和长期不良事件。使用SPSS软件进行统计分析，p值<0.05具有统计学意义。
筛查前外阴阴道萎缩症状评分中位数为4分，最困扰的症状是“外阴周围干燥感”。激光治疗后评分显著降低。治疗前阴道黏膜图像分析的平均百分比为34.7±16.1%，在完成激光治疗疗程后的1个月和3个月时，该指标显著升高，平均变化分别为25.0±12.2%和34.8±15.5%。对于阴道pH值，治疗前平均pH值为7.5±1.0，3个月后平均下降0.9±1.3，差异有统计学意义，p值<0.01。未出现严重并发症，所有患者对治疗均满意。
二氧化碳点阵激光可改善外阴阴道萎缩症状，至少在3个月内安全有效地改善阴道健康状况。
