Obstetrics and Gynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy.
ASST Monza, Ospedale San Gerardo, 20900 Monza, Italy.
Medicina (Kaunas). 2022 Jun 6;58(6):770. doi: 10.3390/medicina58060770.
Vulvovaginal atrophy (VVA) is a chronic progressive disease involving the female genital apparatus and lower urinary tract. This condition is related to hypoestrogenism consequent to menopause onset but is also due to the hormonal decrease after adjuvant therapy for patients affected by breast cancer. Considering the high prevalence of VVA and the expected growth of this condition due to the increase in the average age of the female population, it is easy to understand its significant social impact. VVA causes uncomfortable disorders, such as vaginal dryness, itching, burning, and dyspareunia, and requires constant treatment, on cessation of which symptoms tend to reappear. The currently available therapies include vaginal lubricants and moisturizers, vaginal estrogens and dehydroepiandrosterone (DHEA), systemic hormone therapy, and Ospemifene. Considering, however, that such therapies have some problems that include contraindications, ineffectiveness, and low compliance, finding an innovative, effective, and safe treatment is crucial. The present data suggest great efficacy and safety of a vaginal laser in the treatment of genital symptoms and improvement in sexual function in patients affected by VVA. The beneficial effect tends to be sustained over the long-term, and no serious adverse events have been identified. The aim of this review is to report up-to-date efficacy and safety data of laser energy devices, in particular the microablative fractional carbon dioxide laser and the non-ablative photothermal Erbium-YAG laser.
外阴阴道萎缩（VVA）是一种涉及女性生殖器官和下尿路的慢性进行性疾病。这种情况与绝经后雌激素水平降低有关，但也与乳腺癌患者辅助治疗后激素水平下降有关。鉴于 VVA 的高患病率以及由于女性人口平均年龄的增加而预期这种情况的增长，很容易理解其对社会的重大影响。VVA 会引起不适的症状，如阴道干燥、瘙痒、灼热和性交困难，需要持续治疗，一旦停止治疗，症状往往会再次出现。目前可用的治疗方法包括阴道润滑剂和保湿剂、阴道雌激素和脱氢表雄酮（DHEA）、全身激素治疗和 Ospemifene。然而，鉴于这些治疗方法存在一些问题，包括禁忌症、无效和低顺应性，因此寻找一种创新、有效和安全的治疗方法至关重要。目前的数据表明，阴道激光治疗 VVA 患者的生殖器症状和性功能改善具有很好的疗效和安全性。这种有益的效果往往会持续很长时间，并且没有发现严重的不良事件。本综述的目的是报告激光能量设备的最新疗效和安全性数据，特别是微剥脱性二氧化碳激光和非剥脱性光热铒 YAG 激光。
