Huang Wen-Chu, Su Chun-Yuan, Wang Yeou-Lih
Division of Urogynecology, Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Nursing, MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei, Taiwan.
Xinshen Obstetrics and Gynecology Clinic, New Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2025 May;64(3):463-468. doi: 10.1016/j.tjog.2025.02.002.
To investigate the changes of vaginal health and vulvovaginal atrophy (VVA) symptoms following CO laser treatment in postpartum breastfeeding women. The number of treatment sessions required to alleviate related symptoms was also determined.
Postpartum healthy women who continued breastfeeding and suffered from VVA related symptoms were included in this prospective study. All the participants underwent three consecutive fractional CO laser treatments using Lumenis AcuPulse system with FemTouch™ handpiece at four-weeks interval. Following each laser treatment, the severity of VVA symptoms and Vaginal Health Index (VHI) score were assessed as subjective and objective outcomes. The changes in VHI score and VVA symptom severity were compared with baseline data to detect the onset of significant improvement.
Thirty postpartum breastfeeding women with VVA symptoms completed the treatment courses and associated measurements. Their age ranged from 25 to 41 with an average of 34.6 years. The mean duration of breastfeeding prior to the initial laser treatment was 3.3 months. Vaginal dryness and dyspareunia were the most bothersome VVA symptoms prior to laser treatment and alleviated after two to three treatment sessions. The significant change of VHI score reaching non-atrophic level was found after the first treatment (media of score post:18 vs. pre:14, p < 0.05) and sustained stable through the following two treatments.
Application of fractional CO vaginal laser on the management of postpartum vulvovaginal atrophy was proven effectively in our study. Objective and subjective improvements were detected after the first and second laser treatment, respectively. Two consecutive laser treatment sessions were clinically sufficient to alleviate VVA related symptoms in these young female population under postpartum breastfeeding.
探讨产后哺乳期妇女接受CO2激光治疗后阴道健康及外阴阴道萎缩（VVA）症状的变化。同时确定缓解相关症状所需的治疗次数。
本前瞻性研究纳入了持续哺乳且患有VVA相关症状的产后健康妇女。所有参与者使用Lumenis AcuPulse系统和FemTouch™手持探头，每隔四周连续进行三次分次CO2激光治疗。每次激光治疗后，评估VVA症状的严重程度和阴道健康指数（VHI）评分，作为主观和客观结果。将VHI评分和VVA症状严重程度的变化与基线数据进行比较，以检测显著改善的开始情况。
30名有VVA症状的产后哺乳期妇女完成了治疗疗程及相关测量。她们的年龄在25至41岁之间，平均年龄为34.6岁。首次激光治疗前的平均哺乳时间为3.3个月。阴道干燥和性交困难是激光治疗前最困扰的VVA症状，在两到三次治疗后得到缓解。首次治疗后发现VHI评分有显著变化，达到非萎缩水平（治疗后评分中位数：18 vs. 治疗前：14，p < 0.05），并在接下来的两次治疗中持续稳定。
在我们的研究中，分次CO2阴道激光应用于产后外阴阴道萎缩的管理被证明是有效的。分别在第一次和第二次激光治疗后检测到客观和主观的改善。连续两次激光治疗在临床上足以缓解这些产后哺乳期年轻女性人群中与VVA相关的症状。
