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绝经后泌尿生殖综合征的光生物调节——一项随机、双盲、对照临床试验的研究方案

Photobiomodulation in post menopause genitourinary syndrome-Study protocol for a randomized, double-blind, controlled clinical protocol.

作者信息

Pereira Silvia Regina Dos Santos, Mesquita-Ferrari Raquel Agnelli, Salviatto Luciana Toledo Costa, Bezerra Cícero Dayves da Silva, Dalapria Vanessa, Mello Erika da Silva, Almeida-Lopes Luciana, Bossini Paulo Sérgio, Gonçalves Marcela Leticia Leal, Deana Alessandro Melo

机构信息

Post Graduation Program in Biophotonics Medicine, Universidade Nove de Julho, São Paulo, SP, Brazil.

Institute of Research and Education in the Health Area (NUPEN), São Carlos, SP, Brazil.

出版信息

PLoS One. 2024 Dec 2;19(12):e0313324. doi: 10.1371/journal.pone.0313324. eCollection 2024.

Abstract

INTRODUCTION

Genitourinary Syndrome of Menopause (GSM) defines a set of symptoms associated with an estrogen deficit involving alterations in organs genitourinary and that results in several urinary, genital, and sexual alterations. Brazilian women live about a third of their life after menopause, where hormonal changes occur along with clinical manifestations, characterized by vaginal and vulvar dryness, burning sensation, discomfort, vulvovaginal irritation, lack of lubrication, dyspareunia and urinary incontinence. Fractionated photothermolysis and radiofrequency systems, alone or in combination were tested to improve GSM.

OBJECTIVE

The goal of this study is to elaborate a protocol to evaluate the clinical response of patients with symptoms of GSM after the application of photobiomodulation in the vulvar region.

METHOD

In this randomized, double-blind, placebo-controlled study protocol, women over 50 years of age who are in the postmenopausal period (amenorrhea for at least 12 months, with no pathology involved) with one or more symptoms of GSM will be randomly divided into two groups. The treatment group (n = 30) will receive four consecutive applications, weekly, using DMC laser diode (λ = 808 nm), 4J per point, 100mW of power, 1,016W/cm2, 8 sites in the vulvar region, The Placebo Group (n = 30) will be handled as treated, but with the laser turned off. The quality of life will be assessed using female sexual functioning index (FSFI-6), urinary incontinence questionnaire (ICIQ-SF), Quality of life will be analyzed using the female sexual functioning index (FSFI-6). The intensity of menopausal symptoms will be evaluated using a visual analogue scale (VAS), the vulvo vaginal atrophy will be measured by the Vaginal Health Index (VHI). Also, the vaginal temperature will be measured using a thermal camera, the pressure of the pelvic floor force (vaginal dynamometer) and a 1-hour Pad Test will be performed to quantify the urinary loss. With this procedure, we intend to obtain an overall better life quality and diminished symptoms in women with GSM. All assessments will be performed prior to the first irradiation and after the last one.

TRIAL REGISTRATION

This protocol is registered at ClinicalTrials.gov under the number NCT05557799.

摘要

引言

更年期泌尿生殖综合征(GSM)定义了一组与雌激素缺乏相关的症状,涉及泌尿生殖器官的改变,并导致多种泌尿、生殖和性功能改变。巴西女性绝经后的生活约占其一生的三分之一,在此期间会发生激素变化并伴有临床表现,其特征为阴道和外阴干燥、烧灼感、不适、外阴阴道刺激、缺乏润滑、性交困难和尿失禁。已对分次光热解和射频系统单独或联合使用进行了测试,以改善GSM。

目的

本研究的目的是制定一项方案,以评估在外阴区域应用光生物调节后有GSM症状患者的临床反应。

方法

在本随机、双盲、安慰剂对照研究方案中,50岁以上处于绝经后期(闭经至少12个月且无相关病理情况)且有一项或多项GSM症状的女性将被随机分为两组。治疗组(n = 30)将每周连续接受四次治疗,使用DMC激光二极管(λ = 808 nm),每点4J,功率100mW,1,016W/cm2,在外阴区域8个部位进行治疗。安慰剂组(n = 30)将接受与治疗组相同的操作,但激光关闭。将使用女性性功能指数(FSFI - 6)评估生活质量,使用尿失禁问卷(ICIQ - SF)评估尿失禁情况。将使用女性性功能指数(FSFI - 6)分析生活质量。将使用视觉模拟量表(VAS)评估更年期症状的强度,通过阴道健康指数(VHI)测量外阴阴道萎缩情况。此外,将使用热成像仪测量阴道温度,使用盆底肌力计(阴道测力计)测量盆底压力,并进行1小时的卫生巾试验以量化尿失禁情况。通过该程序,我们旨在使GSM女性获得总体更好的生活质量并减轻症状。所有评估将在首次照射前和最后一次照射后进行。

试验注册

本方案已在ClinicalTrials.gov上注册,注册号为NCT05557799。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d3b/11611114/7a085367be95/pone.0313324.g001.jpg

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