Department of Dermatology, University of California Irvine, Irvine, California.
Department of Dermatology, Sutter Fairfield Health, Fairfield, California.
Dermatol Surg. 2021 Apr 1;47(4):489-494. doi: 10.1097/DSS.0000000000002845.
Vaginal rejuvenation is a topic of interest to multiple specialties, including dermatologists, plastic and reconstructive surgeons, urologists, and gynecologists. Evidence suggests that minimally invasive, energy-based devices-radiofrequency and laser therapy-are effective at vaginal tightening and decreasing symptoms of genitourinary syndrome of menopause (GSM) and/or vulvovaginal atrophy (VVA).
A systematic review was completed using PubMed in November 2018 with search terms "vaginal" or "vagina" and "rejuvenation" or "tightening" or "laxity" or "radiofrequency" or "laser," as well as "genitourinary syndrome of menopause," "pelvic prolapse," "atrophic vaginitis," "vulvovaginal atrophy," "sexual function," "urinary incontinence," and "radiofrequency" or "laser." Inclusion criteria were articles written in English and clinical trials or case reports/series dealing with human subjects.
We identified 59 studies (3,609 women) treated for vaginal rejuvenation using either radiofrequency or fractional ablative laser therapy. Studies report improvement in symptoms of GSM/VVA and sexual function, high patient satisfaction, and minor adverse events, including treatment-associated pain, swelling, or vaginal discharge.
This review demonstrates radiofrequency and laser are efficacious for the treatment of vaginal laxity and/or atrophy. Further research needs to be completed to determine which specific pathologies can be treated, if maintenance treatment is necessary, and long-term safety concerns.
阴道年轻化是皮肤科医生、整形和重建外科医生、泌尿科医生和妇科医生等多个专业领域关注的话题。有证据表明,微创、能量型设备——射频和激光治疗——在阴道紧缩和减少女性生殖泌尿系统综合征(GSM)和/或外阴阴道萎缩(VVA)症状方面是有效的。
2018 年 11 月,我们通过 PubMed 进行了系统评价,使用的检索词包括“阴道”或“vagina”和“年轻化”或“收紧”或“松弛”或“射频”或“激光”,以及“女性生殖泌尿系统综合征”、“盆腔器官脱垂”、“萎缩性阴道炎”、“外阴阴道萎缩”、“性功能”、“尿失禁”和“射频”或“激光”。纳入标准为用英文撰写且涉及人类受试者的临床试验或病例报告/系列的文章。
我们确定了 59 项研究(3609 名女性),这些研究使用射频或分束消融激光治疗阴道年轻化。研究报告称 GSM/VVA 和性功能症状得到改善,患者满意度高,且仅有轻微的不良反应,包括与治疗相关的疼痛、肿胀或阴道分泌物。
本综述表明射频和激光在治疗阴道松弛和/或萎缩方面是有效的。需要进一步研究以确定可以治疗哪些特定的病理,是否需要维持治疗,以及长期的安全问题。