Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause.
Gambacciani M, Levancini M, Cervigni M.
The aim of this study was to evaluate the effects of Vaginal Erbium Laser (VEL) in the treatment of postmenopausal women (PMW) suffering from genitourinary syndrome of menopause (GSM). GSM was assessed in PMW before and after VEL (1 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 mcg of Estriol, twice weekly for 3 months; n=25). GSM was evaluated either with subjective (visual analog scale, VAS) and objective (Vaginal Health Index Score, VHIS) measures. In addition, in 19 of these PMW 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. 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 PMW suffering from mild-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. This pilot study demonstrates that VEL induces a significant improvement of GSM, including vaginal dryness, dyspareunia and mild-moderate SUI. Further studies are needed to explore the role of laser treatments in the management of GSM.