Ghanbari Zinat, Deldar Pesikhani Maryam, Eftekhar Tahereh, Kazemi Maryam, Akbari Razieh, Parsapur Mahdieh, Ghaemi Marjan, Dashtkoohi Mohadese
Department of Obstetrics & Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Lasers Med Sci. 2024 Nov 27;15:e59. doi: 10.34172/jlms.2024.59. eCollection 2024.
Genitourinary syndrome of menopause (GSM) is a common complication secondary to estrogen depletion which leads to tissue changes in the female genitourinary tract. Here, we sought to investigate the short- and long-term effects of CO laser therapy on symptoms of GSM in postmenopausal women. In this clinical trial, 47 postmenopausal women with symptoms of GSM were included. Participants underwent vaginal and extra-vaginal CO fractional laser treatment in three sessions, with intervals of one month between each session. Symptom severity, including itching, dyspareunia, vaginal discharge, and dryness, was assessed at each session using a modified Vaginal Health Index (VHI), where the intensity was rated on a Visual Analog Scale (VAS) from 1 to 10 (1 indicating minimal symptoms and 10 representing maximum severity). Additionally, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was administered. Patients were followed for one to three years after the final laser treatment session. The scores of all subscales, including itching, dyspareunia, urinary incontinence, vaginal discharge, and dryness, improved significantly following three sessions of CO fractional laser ( values<0.001). However, except for the urinary incontinence domain (=0.058), none of the symptoms maintained improved after one to three years from the last intervention. CO fractional laser treatment is appropriate for treating symptoms related to GSM. But it seems that it needs to be used continuously for the maintenance effect on itching, dyspareunia, urinary incontinence, vaginal discharge, and dryness. The exact timing of laser sessions should be identified in further studies since the beneficial outcomes of the intervention seem temporary.
更年期泌尿生殖综合征（GSM）是雌激素缺乏继发的常见并发症，可导致女性泌尿生殖道组织发生变化。在此，我们旨在研究CO2激光治疗对绝经后女性GSM症状的短期和长期影响。在这项临床试验中，纳入了47名有GSM症状的绝经后女性。参与者接受了三次阴道和阴道外CO2分次激光治疗，每次治疗间隔一个月。每次治疗时使用改良的阴道健康指数（VHI）评估症状严重程度，包括瘙痒、性交困难、阴道分泌物和干燥，强度根据视觉模拟量表（VAS）从1到10进行评分（1表示症状最轻，10表示最严重）。此外，还进行了国际尿失禁咨询问卷-尿失禁简表（ICIQ-UI SF）评估。在最后一次激光治疗后，对患者进行了1至3年的随访。经过三次CO2分次激光治疗后，所有子量表的评分，包括瘙痒、性交困难、尿失禁、阴道分泌物和干燥，均有显著改善（P值<0.001）。然而，除尿失禁领域外（P = 0.058），从最后一次干预后的1至3年，没有一种症状持续改善。CO2分次激光治疗适用于治疗与GSM相关的症状。但似乎需要持续使用才能对瘙痒、性交困难、尿失禁、阴道分泌物和干燥产生维持效果。由于干预的有益效果似乎是暂时的，因此在进一步研究中应确定激光治疗的具体时间。
