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阴道铒激光治疗对有乳腺癌病史和泌尿生殖系统绝经综合征症状女性性功能和阴道健康的影响:一项前瞻性研究。

The effect of vaginal erbium laser treatment on sexual function and vaginal health in women with a history of breast cancer and symptoms of the genitourinary syndrome of menopause: a prospective study.

机构信息

Department of Gynecology and Obstetrics, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Department of Gynecology and Obstetrics, Federal University of Goiás, Goiânia, Goiás, Brazil.

出版信息

Menopause. 2019 Sep;26(9):1052-1058. doi: 10.1097/GME.0000000000001353.

Abstract

OBJECTIVES

To assess the effects of vaginal erbium laser treatment on the vaginal health and sexual function of postmenopausal women with a history of breast cancer.

METHODS

An open, prospective, therapeutic intervention study was conducted with 24 postmenopausal women with a history of breast cancer and vaginal dryness, and/or dyspareunia, who had not used vaginal hormone therapy for at least 6 months. The women were treated using a 2,940-nm Erbium: YAG laser (Etherea-MX, Athena, São Carlos, São Paulo, Brazil), with 90 and 360 scanning scopes, between August, 2017 and October, 2017 in a private clinic in a city of southeastern Brazil. Vaginal erbium laser treatment was performed at three sessions with a 30-day interval between each session. Sexual function was assessed before and 1 month after treatment using the Short Personal Experiences Questionnaire. Questions related to genitourinary symptoms were also applied. Vaginal health was assessed before each laser session using the Vaginal Health Index Score.

RESULTS

Mean age was 53.7 years. Vaginal health improved, as shown by an increased overall score (P < 0.001). The effect size was large between pretreatment and post-treatment scores for vaginal elasticity, fluid volume, epithelial integrity, and moisture. The effect size was also significant for the overall sexual function score and for the score in the dyspareunia domain between pretreatment and 1 month after the final treatment session.

CONCLUSION

Vaginal erbium laser may represent a novel therapeutic option for improving vaginal health and sexual function in postmenopausal women with a history of breast cancer.

摘要

目的

评估阴道铒激光治疗对有乳腺癌病史的绝经后妇女阴道健康和性功能的影响。

方法

这是一项开放性、前瞻性、治疗干预研究,共纳入 24 名有乳腺癌病史且阴道干燥和/或性交困难、至少 6 个月未使用阴道激素治疗的绝经后妇女。这些妇女于 2017 年 8 月至 10 月在巴西东南部某城市的一家私人诊所使用 2,940nm 铒:YAG 激光(Etherea-MX,Athena,São Carlos,São Paulo,巴西)进行治疗,激光探头为 90°和 360°扫描镜,治疗共进行 3 次,每次治疗间隔 30 天。在治疗前和治疗后 1 个月,使用简短个人体验问卷评估性功能。还应用了与泌尿生殖系统症状相关的问题。在每次激光治疗前,使用阴道健康指数评分评估阴道健康状况。

结果

平均年龄为 53.7 岁。阴道健康状况得到改善,总评分增加(P<0.001)。阴道弹性、液体量、上皮完整性和湿度等指标在治疗前后的评分差异有统计学意义,阴道健康的效应量较大。在治疗前后的总性功能评分和治疗结束后 1 个月的性交困难域评分差异也有统计学意义,效应量较大。

结论

阴道铒激光可能为改善有乳腺癌病史的绝经后妇女的阴道健康和性功能提供一种新的治疗选择。

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