Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause

Abstract

Objectives: To evaluate the safety and long-term efficacy of fractional CO₂ laser treatment in reducing the severity of symptoms of genitourinary syndrome of menopause (GSM) in menopausal women.

Study design: 102 women presenting with symptomatic GSM were treated with the fractional CO₂ laser (MonaLisa Touch, DEKA) system across a series of treatments delivered at intervals of six or more weeks. The Australian Pelvic Floor Questionnaire was used to gather data on sexual function and side-effects at three time-points across the study period (prospective panel design study). Wilcoxon signed-rank tests were used to detect statistically and clinically significant changes in sexual function and side-effects occurring from pre- to post-treatment. The primary outcome of this study was an improvement of the symptoms of GSM. The secondary outcome included bladder function and prolapse symptoms.

Results: A total of 102 women suffering from moderate to severe GSM were recruited. Eighty-four percent experienced significant improvement in their symptoms after CO₂ laser treatment. Scores on measures of sexual function, dyspareunia, and bothersomeness of sexual issues were improved from pre-treatment to long-term (12-24 month) follow-up. Furthermore, there were improvements on measures of bladder function (P=0.001), prolapse (P=0.001), vaginal sensation (P=0.001), vaginal lubrication (P<0.001) and urge incontinence (P=0.003) from the pre-treatment assessment to the second assessment (i.e. after the third treatment).

Conclusions: In this study, fractional microablative CO₂ laser treatment was associated with an improvement in symptoms of GSM and sexual function.

Keywords: Bladder control; Fractional CO(2) laser; Genitourinary syndrome of menopause; Menopause; Sexual function.