Jankovic Svetlana, Rovcanin Marija, Zamurovic Milena, Jovanovic Branka, Raicevic Tatjana, Tomic Ana
Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia.
Healthcare (Basel). 2024 Jul 11;12(14):1385. doi: 10.3390/healthcare12141385.
Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder-urethral regions related to menopause changes, negatively influencing woman's quality of life and sexual activity. Fractional micro-ablative CO laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning ( < 0.001), as well as dyspareunia ( = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution ( < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 ( < 0.001). Therefore, using a three-cycle fractional CO laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women.
更年期泌尿生殖综合征（GSM）包括一系列与更年期变化相关的外阴阴道和/或膀胱尿道区域的令人痛苦的症状，对女性的生活质量和性活动产生负面影响。分次微剥脱性CO2激光治疗已显示出将阴道上皮恢复到类似于绝经前状态的潜力，从而改善与GSM相关的主观症状。我们对73名因GSM症状接受CO2激光治疗的性活跃绝经后妇女进行了一项前瞻性试点研究，同时通过女性性功能指数（FSFI）问卷评估阴道健康指数评分（VHIS）和性功能。激光治疗导致VHIS降低以及患者报告的外阴阴道萎缩（VVA）症状减轻，阴道瘙痒、干燥和烧灼感的患病率显著降低（<0.001），性交困难患病率也显著降低（=0.002）。尿失禁、尿急和阴道坠胀感的发生率显著降低，膀胱膨出分期改善，达到1期或完全缓解（<0.001）。治疗后FSFI总分和各领域得分显著更高，表明性功能更好，治疗后得分中位数为25（<0.001）。因此，使用三周期分次CO2激光是减轻绝经后妇女与GSM相关的泌尿生殖不适的有效选择。
