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Meta-Analysis
. 2023 Sep 1;30(9):980-987.
doi: 10.1097/GME.0000000000002220. Epub 2023 Jul 25.

Efficacy and safety of carbon dioxide laser therapy compared with sham for genitourinary syndrome of menopause management: a meta-analysis of randomized clinical trials

Yuliana W Gunawan  1 , Yunita Erlina  2
Affiliations
Meta-Analysis

Efficacy and safety of carbon dioxide laser therapy compared with sham for genitourinary syndrome of menopause management: a meta-analysis of randomized clinical trials

Yuliana W Gunawan et al. Menopause. .

Abstract

Importance: Data on whether the carbon dioxide (CO 2 ) laser is useful for treatment of genitourinary syndrome of menopause (GSM) are inconsistent.

Objective: This meta-analysis evaluated the benefits and safety of CO 2 laser compared with sham treatment of GSM.

Evidence review: A relevant literature search of Europe PMC, MEDLINE, Scopus, and ClinicalTrials.gov databases using specific keywords was conducted. The results of continuous variables were pooled into the standardized mean difference (SMD), whereas dichotomous variables were pooled into odds ratio with 95% confidence intervals (95% CI) using random-effects models. A funnel plot was used to assess for the presence of publication bias.

Findings: A total of six randomized clinical trials were included. Pooled analysis revealed that CO 2 laser therapy was associated with a higher reduction in the Vaginal Assessment Scale (SMD, -0.81 [95% CI, -1.59 to -0.04]; P = 0.04; I2 = 88%) and Urinary Distress Inventory short form (SMD, -0.45 [95% CI, -0.84 to -0.06]; P = 0.02; I2 = 0%), and greater patient satisfaction rate (odds ratio, 5.46 [95% CI, 2.23 to 13.37]; P = 0.0002; I2 = 0%) when compared with sham-only treatment. Meanwhile, the Female Sexual Function Index, Vaginal Health Index, and Patient Global Impression Improvement did not differ significantly between groups. Adverse events were only mild with no serious adverse events reported.

Conclusions and relevance: CO 2 laser therapy may improve the overall treatment of GSM with a relatively good safety profile. However, further randomized clinical trials with larger sample sizes are still needed to confirm the results of this study.

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Conflict of interest statement

Financial disclosure/conflicts of interest: None reported.

References

    1. McKinlay SM. The normal menopause transition: an overview. Maturitas 1996;23:137–145. doi: 10.1016/0378-5122(95)00985-x - DOI
    1. Gandhi J, Chen A, Dagur G, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol 2016;215:704–711. doi: 10.1016/j.ajog.2016.07.045 - DOI
    1. Kim HK, Kang SY, Chung YJ, Kim JH, Kim MR. The Recent Review of the Genitourinary Syndrome of Menopause . J Menopausal Med 2015;21:65–71. doi: 10.6118/jmm.2015.21.2.65 - DOI
    1. Sarmento ACA, Costa APF, Vieira-Baptista P, Giraldo PC, Eleutério J Jr., Gonçalves AK. Genitourinary syndrome of menopause: epidemiology, physiopathology, clinical manifestation and diagnostic. Front Reprod Health 2021;3:779398. doi: 10.3389/frph.2021.779398 - DOI
    1. Palacios S, Castelo-Branco C, Currie H, et al. Update on management of genitourinary syndrome of menopause: a practical guide. Maturitas 2015;82:308–313. doi: 10.1016/j.maturitas.2015.07.020 - DOI

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