5| Volume 211, P201, April 2017

CO2-laser therapy in women with severe symptoms of vaginal atrophy: a pilot histopathological study

      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.
      Age56.6 ± 3.3*
      Years since the last menstrual period9.3 ± 6.1*
      Body mass index25.4 ± 3.8*
      Educational level
       University23/26 (89)*
       Secondary3/26 (11)*
       Yes7/26 (27)*
       No19/26 (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.
      Baseline1-month after 3 CO2-laser therapiesp-value
      Thickness of the vaginal epithelium (μm)125.7 ± 53.4179.0 ± 60.8<0.001
      Vaginal Maturation Value13.1 ± 17.040.6 ± 13.4<0.001
      Vaginal Health Index Scale7.9 ± 1.819.4 ± 3.3<0.001
      Vaginal pH5.4 ± 0.64.6 ± 0.4<0.001
      10-cm Visual Analogue Scale of the vaginal symptoms
      Overall9.6 ± 0.84.0 ± 2.2<0.001
      Dyspareunia9.6 ± 0.84.0 ± 2.2<0.001
      Dryness9.1 ± 1.03.2 ± 1.7<0.001
      Burning (n = 6)6.33 ± 3.40.7 ± 1.20.03
      Itching (n = 5)6.2 ± 3.81.8 ± 1.80.04
      Dysuria (n = 6)1.8 ± 0.80.3 ± 0.50.02