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. 2015 Oct;18(5):757-63.
doi: 10.3109/13697137.2015.1045485.

Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause

Affiliations

Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause

M Gambacciani et al. Climacteric. 2015 Oct.

Abstract

Aim To evaluate the effects of the vaginal erbium laser (VEL) in the treatment of postmenopausal women suffering from genitourinary syndrome of menopause (GSM). Method GSM was assessed in postmenopausal women before and after VEL (one treatment every 30 days, for 3 months; n = 45); the results were compared with the effects of a standard treatment for GSM (1 g of vaginal gel containing 50 μg of estriol, twice weekly for 3 months; n = 25). GSM was evaluated with subjective (visual analog scale, VAS) and objective (Vaginal Health Index Score, VHIS) measures. In addition, in 19 of these postmenopausal women suffering from stress urinary incontinence (SUI), the degree of incontinence was evaluated with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before and after VEL treatments. Results VEL treatment induced a significant decrease of VAS of both vaginal dryness and dyspareunia (p < 0.01), with a significant (p < 0.01) increase of VHIS. In postmenopausal women suffering from mild to moderate SUI, VEL treatment was associated with a significant (p < 0.01) improvement of ICIQ-SF scores. The effects were rapid and long lasting, up to the 24th week of the observation period. VEL was well tolerated with less than 3% of patients discontinuing treatment due to adverse events. Conclusion This pilot study demonstrates that VEL induces a significant improvement of GSM, including vaginal dryness, dyspareunia and mild to moderate SUI. Further studies are needed to explore the role of laser treatments in the management of GSM.

Keywords: DYSPAREUNIA; ERBIUM LASER; GENITOURINARY SYNDROME OF MENOPAUSE; MENOPAUSE; STRESS URINARY INCONTINENCE; VAGINAL ATROPHY.

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Figures

Figure 1
Figure 1. Effect of second-generation laser thermotherapy on vaginal dryness (upper panel) and dyspareunia (lower panel) using the visual analog score (VAS) on a 10-point scale for the women receiving laser treatment (n = 43) and the women receiving estriol (n = 19). See text for details. *, p < 0.01 vs. corresponding basal values in both groups; **, p < 0.05 vs. estriol basal values and corresponding laser group values
Figure 2
Figure 2. Effect of second-generation laser thermotherapy on the Vaginal Health Score Index (VHIS) for the women receiving laser treatment (n = 43) and the women receiving estriol (n = 19). See text for details. *, p < 0.01 vs. corresponding basal values in both groups; **, p < 0.05 vs. estriol basal values and corresponding laser group values
Figure 3
Figure 3. Effect of second-generation laser thermotherapy on International Consultation on Incontinence Questionnaire (ICIQ-SF) score in 19 postmenopausal women suffering from stress urinary incontinence. *, p < 0.01 vs. corresponding basal values. See text for details

Comment in

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