Universidade Federal do Rio Grande do Norte NatalRN Brazil Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Universidade Potiguar NatalRN Brazil Universidade Potiguar, Natal, RN, Brazil.
Rev Bras Ginecol Obstet. 2024 May 27;46. doi: 10.61622/rbgo/2024rbgo38. eCollection 2024.
This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM).
Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction.
RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy.
Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author.
Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=-0.85; 95% CI=-1.59 to -0.10), dryness (MD=-0.62; 95% CI=-1.12 to -0.12) and burning (MD= -0.64; 95% CI=-1.28 to -0.01) decreased. No serious adverse effects were reported.
CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.
本荟萃分析旨在更新随机对照试验（RCT）的证据，评估激光治疗女性泌尿生殖系统绝经综合征（GSM）的有效性和安全性。
系统检索了 PubMed、Embase、Scopus、Web of Science、CENTRAL、CINAHL 和临床试验数据库（www.trialscentral.org、www.controlled-trials.com 和 clinicaltrials.gov），直至 2023 年 5 月，无语言和发表年份限制。
纳入的 RCT 研究对象为诊断为 GSM 的女性，干预措施为阴道激光治疗（CO2 激光或 Er：YAG 激光）与安慰剂（假治疗）、无治疗或阴道雌激素治疗进行比较。
两位作者根据标题和摘要评估出版物是否纳入，然后再审查相关的全文文章。在审查过程中出现的分歧通过协商解决，如有需要，可请第三位作者参与。
本综述共纳入 12 项 RCT，共计 5147 名参与者。CO2 激光治疗组的阴道健康指数（VHI）显著改善（MD=2.21；95% CI=1.25 至 3.16），而性交困难（MD=-0.85；95% CI=-1.59 至 -0.10）、干燥（MD=-0.62；95% CI=-1.12 至 -0.12）和灼热感（MD=-0.64；95% CI=-1.28 至 -0.01）减少。未报告严重不良事件。
与假激光相比，CO2 激光可提高 VHI 评分，减少性交困难、干燥和灼热感，但证据质量低，因此无法推荐激光治疗 GSM。
