Introduction and aim of the study: CO2-Laser therapy represents a novel proposal for the vaginal atrophy (VA) management.1-33 Nevertheless, lack of relevant histopathological studies regarding its effect on the vaginal epithelium exist. The aim of our study was to assess the alterations of vaginal epithelium thickness (VE-Thick) following CO2-Laser therapy in postmenopausal women with severe VA-symptoms.
Materials and methods: Three-therapies/month were applied in 26 women with severe VA-symptoms. Primary outcome of the study was the evaluation of VE-Thick. Secondary outcomes involved: Vaginal Maturation Value (VMV), Vaginal Health Index Scale (VHIS), vaginal pH and 10-cm Visual Analogue Scale of symptoms’ severity (overall, dyspareunia, dryness, burning, itching, dysuria). Assessment was performed at baseline and 1-month after last therapy.
Results: VE-Thick, VMV and VHIS were significantly increased, while Vaginal pH and severity of all symptoms were significantly decreased post-CO2-Laser therapy.
Interpretation of results: CO2-Laser may result in alleviation of VA-symptoms potentially through the restoration of local pathophysiology.
Conclusions: CO2-Laser therapy increases significantly the VE-Thick resulting in alleviation of VA-symptoms. More studies are needed to confirm our results (Table 1, Table 2).
Table 1Baseline characteristics of the women included in the study.
| Number | 26 |
|---|---|
| Age | 56.6 ± 3.3* |
| Years since the last menstrual period | 9.3 ± 6.1* |
| Body mass index | 25.4 ± 3.8* |
| Educational level | |
| University | 23/26 (89)* |
| Secondary | 3/26 (11)* |
| Smoking | |
| Yes | 7/26 (27)* |
| No | 19/26 (73)* |
Data are displayed as mean ± SD and as percentage.
Table 2Changes on vaginal epithelium thickness and signs/symptoms of Vaginal Atrophy following CO2-Laser therapy.
| Baseline | 1-month after 3 CO2-laser therapies | p-value | |
|---|---|---|---|
| Thickness of the vaginal epithelium (μm) | 125.7 ± 53.4 | 179.0 ± 60.8 | <0.001 |
| Vaginal Maturation Value | 13.1 ± 17.0 | 40.6 ± 13.4 | <0.001 |
| Vaginal Health Index Scale | 7.9 ± 1.8 | 19.4 ± 3.3 | <0.001 |
| Vaginal pH | 5.4 ± 0.6 | 4.6 ± 0.4 | <0.001 |
| 10-cm Visual Analogue Scale of the vaginal symptoms | |||
| Overall | 9.6 ± 0.8 | 4.0 ± 2.2 | <0.001 |
| Dyspareunia | 9.6 ± 0.8 | 4.0 ± 2.2 | <0.001 |
| Dryness | 9.1 ± 1.0 | 3.2 ± 1.7 | <0.001 |
| Burning (n = 6) | 6.33 ± 3.4 | 0.7 ± 1.2 | 0.03 |
| Itching (n = 5) | 6.2 ± 3.8 | 1.8 ± 1.8 | 0.04 |
| Dysuria (n = 6) | 1.8 ± 0.8 | 0.3 ± 0.5 | 0.02 |
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© 2017 Published by Elsevier Inc.
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