Department of Obstetrics and Gynaecology, University Hospitals Dorset, Poole, UK.
Climacteric. 2020;23(sup1):S6-S10. doi: 10.1080/13697137.2020.1774536.
Transvaginal laser therapies are being increasingly used for a variety of indications, particularly genitourinary syndrome of the menopause and stress urinary incontinence. This article reviews the current data pertaining to the place of these devices in current clinical practice. Whilst there has been a rapid increase in the number of publications over the last few years, many of the studies are of small numbers, short duration, and poor quality and are device-sponsored. The evidence suggests that vaginal laser therapy with either the erbium-doped yttrium aluminum garnet laser (FotonaSmooth) or the CO laser (MonaLisa Touch) is an effective intervention for the relief of symptoms of vulvovaginal atrophy in symptomatic women. The benefits of three laser treatments appear to last for at least 12 months and the procedure is generally well tolerated, with transient minor discomfort being the most common adverse event. Whilst the vaginal laser certainly has the potential to be an alternative treatment to vaginal estrogens for those groups of women, such as breast cancer patients, who cannot take them, there are still many unanswered questions about the role of vaginal laser therapy in clinical practice, particularly in relation to standard conservative management. The place of vaginal laser therapy in other conditions such as stress urinary incontinence is less clear. The outcomes from several ongoing randomized trials should help to answer some of these questions. In the meantime, the use of vaginal laser devices should be confined to clinical trials.
经阴道激光治疗因其广泛的适应证而被日益应用，尤其是在女性生殖泌尿道综合征和压力性尿失禁方面。本文回顾了这些设备在目前临床实践中的应用的相关数据。尽管在过去几年中，相关出版物的数量迅速增加，但许多研究的样本量较小、持续时间较短且质量较差，并且这些研究都得到了设备制造商的赞助。有证据表明，铒石榴石激光（FotonaSmooth）或 CO2 激光（MonaLisa Touch）阴道激光治疗对于缓解有症状的女性的阴道萎缩症状是一种有效的干预措施。三次激光治疗的益处似乎至少持续 12 个月，并且该程序通常具有良好的耐受性，最常见的不良反应是短暂的轻微不适。虽然阴道激光对于那些不能使用阴道雌激素的女性（如乳腺癌患者）来说，确实有可能成为阴道雌激素治疗的替代方法，但关于阴道激光治疗在临床实践中的作用，特别是在标准保守治疗方面，仍有许多未解决的问题。阴道激光治疗在其他疾病中的作用，如压力性尿失禁，还不太明确。几项正在进行的随机试验的结果将有助于回答其中的一些问题。同时，阴道激光设备的使用应仅限于临床试验。
