Gambacciani M, Fidecicchi T
Menopause and Osteoporosis Unit, San Rossore Clinical Center, Pisa, Italy.
Department of Obstetrics and Gynecology, Pisa University Hospital, Pisa, Italy.
Climacteric. 2022 Apr;25(2):208-211. doi: 10.1080/13697137.2021.2014809. Epub 2022 Jan 10.
This prospective pilot study aimed to evaluate the effects of associating a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with a vaginal erbium laser (VEL), as a non-ablative photothermal therapy for superficial dyspareunia in postmenopausal women (PMW) suffering from genitourinary syndrome of menopause (GSM).
Two groups of sexually active PMW reporting superficial dyspareunia were selected: one (15 patients, VEL) was treated using an erbium:yttrium-aluminum-garnet laser crystal (XS Fotona SMOOTH; Fotona, Ljubljana, Slovenia) with a wavelength of 2940 nm; in the other group (15 patients, VEL + Nd:YAG) this treatment was followed by Nd:YAG laser (Fotona SP Dynamis, PIANO mode) treatment. Treatment consisted of three laser applications at 30-day intervals. Symptoms were assessed before, after each laser application and after 1 and 3 months from the end of the treatment, using the subjective visual analog scale (VAS) for superficial dyspareunia.
Both groups showed a rapid and significant improvement of superficial dyspareunia over time ( < 0.001) independently from age and years since menopause. The VEL + Nd:YAG group showed a greater improvement of superficial dyspareunia ( < 0.001); this difference was evident since the first treatment and remained stable over time.
The addition of Nd:YAG to VEL may induce greater improvement in superficial dyspareunia in PMW with GSM.
本前瞻性试点研究旨在评估钕钇铝石榴石(Nd:YAG)激光与阴道铒激光(VEL)联合使用,作为一种非剥脱性光热疗法,用于治疗患有更年期泌尿生殖综合征(GSM)的绝经后女性(PMW)的浅表性交疼痛。
选择两组报告有浅表性交疼痛的性活跃PMW:一组(15例患者,VEL组)使用波长为2940 nm的铒钇铝石榴石激光晶体(XS Fotona SMOOTH;Fotona,卢布尔雅那,斯洛文尼亚)进行治疗;另一组(15例患者,VEL+Nd:YAG组)在该治疗后进行Nd:YAG激光(Fotona SP Dynamis,PIANO模式)治疗。治疗包括每隔30天进行三次激光照射。在每次激光照射前、照射后以及治疗结束后1个月和3个月,使用主观视觉模拟量表(VAS)评估浅表性交疼痛的症状。
两组患者的浅表性交疼痛均随时间迅速且显著改善(<0.001),与年龄和绝经年限无关。VEL+Nd:YAG组的浅表性交疼痛改善更为明显(<0.001);这种差异自首次治疗后就很明显,并随时间保持稳定。
在VEL治疗中添加Nd:YAG可能会使患有GSM的PMW的浅表性交疼痛得到更大改善。