Gao Lin, Wen Wei, Wang Yuanli, Li Zhaoyang, Dang Erle, Yu Lei, Zhou Chenxi, Lu Meiheng, Wang Gang
Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 85, Wujin Road, Shanghai 200080, China.
J Clin Med. 2022 Sep 2;11(17):5201. doi: 10.3390/jcm11175201.
Background: Vaginal laxity (VL) is characterized by the relaxing of the vaginal wall that affects the quality of life and sexual function of patients. The current management of VL such as Kegel exercises and topical or systemic hormonal replacement results in unsatisfactory outcomes; thus, novel modalities are needed to improve the efficacy. Vaginal fractional carbon dioxide (CO2) laser treatment has shown growing applications for the treatment of VL, but results show nonconformities due to the lack of objective evaluations. In this study, we aimed to validate the clinical efficacy and biophysical benefits of fractional CO2 laser treatment for VL patients with the incorporation of objective approaches. Methods: This is a descriptive study without controls. A total of 29 patients were enrolled and treated with two sessions of FemTouch vaginal fractional CO2 laser, with a one-month interval between sessions. Both subjective and objective measurements, including female sexual function index (FSFI), vaginal health index score (VHIS), vaginal tactile imaging (VTI), and histology were used to validate the clinical efficacy and biophysical benefits after treatment. Results: The overall FSFI scores and VHIS scores after the first and second treatment sessions were significantly higher than the baseline scores (p < 0.01, n = 29). VTI measurements showed a significant increase in maximal pressure resistance (kPa) of both the anterior and posterior vaginal walls at a 10−12-month post-treatment visit compared with pre-treatment controls (p < 0.001; n = 16). Histological examination showed that laser treatment led to increases in the thickness of the stratified squamous epithelium layer and density of connective tissues in the lamina propria. Conclusions: Fractional CO2 vaginal laser treatment can improve both vaginal health and sexual function and restore vaginal biomechanical properties by increasing vaginal tissue tightening and improving vaginal tissue integrity in Asian women. Our data support that fractional CO2 vaginal laser is a valid treatment modality for VL.
阴道松弛的特征是阴道壁松弛，这会影响患者的生活质量和性功能。目前针对阴道松弛的治疗方法，如凯格尔运动以及局部或全身激素替代疗法，效果并不理想；因此，需要新的治疗方式来提高疗效。阴道分次二氧化碳（CO₂）激光治疗在阴道松弛治疗中的应用越来越广泛，但由于缺乏客观评估，结果存在不一致性。在本研究中，我们旨在通过采用客观方法来验证分次CO₂激光治疗对阴道松弛患者的临床疗效和生物物理益处。
这是一项无对照的描述性研究。共纳入29例患者，采用FemTouch阴道分次CO₂激光进行两次治疗，两次治疗间隔1个月。使用主观和客观测量方法，包括女性性功能指数（FSFI）、阴道健康指数评分（VHIS）、阴道触觉成像（VTI）和组织学检查，来验证治疗后的临床疗效和生物物理益处。
第一次和第二次治疗后的总体FSFI评分和VHIS评分均显著高于基线评分（p < 0.01，n = 29）。VTI测量显示，与治疗前对照相比，治疗后10 - 12个月时阴道前壁和后壁的最大抗压强度（kPa）显著增加（p < 0.001；n = 16）。组织学检查表明，激光治疗导致复层鳞状上皮层厚度增加，固有层结缔组织密度增加。
分次CO₂阴道激光治疗可以改善阴道健康和性功能，并通过增加阴道组织紧致度和改善阴道组织完整性来恢复阴道生物力学特性，对亚洲女性的阴道松弛有效。我们的数据支持分次CO₂阴道激光是治疗阴道松弛的有效治疗方式。
