Microablative Erbium: YAG Laser Therapy for Vulvodynia – A Report on Efficacy, Safety, and Treatment Satisfaction

Sexual Medicine - Tập 9 - Trang 100432 - 2021
Gerda Trutnovsky1, Brigitte Bliem1, Elfriede Greimel1, Karl Tamussino1, Daniela Gold1
1Department of Obstetrics and Gynecology, Medical University of Graz, Austria

Tóm tắt

Abstract Introduction Treatment for vulvodynia is challenging and a multidisciplinary approach is recommended. Aim To examine the effectiveness, safety and treatment satisfaction of vulvovaginal microablative laser treatment for vulvodynia. Methods Case study of women who received laser treatment as part of a multidisciplinary treatment program for vulvodynia. Subjective improvement was compared to a retrospective cohort of women treated for vulvodynia without LASER therapy. LASER treatment was offered to women with vulvodynia presenting to a gynecologic pain clinic of a tertiary university hospital. LASER treatments were performed with a microablative 2,940 nm Er:YAG LASER and potentially repeated after 1 month. Main outcome measures Change in local vulvar pain was assessed with cotton-swab tests and rated on a numeric rating scale (NRS). Treatment discomfort and short-term adverse events were recorded. The Freiburg Index of Patient Satisfaction was used to assess treatment satisfaction. Subjective symptom improvement was assessed with the Patient Global Impression of Improvement questionnaire. Results 35 women received at least 1 laser treatment, with overall mild treatment adverse effects (mean pain NRS 2.4 ± 1.9) and good treatment satisfaction (mean total score of 27.6 ±5.1; potential range 8–32). One month after last LASER treatment the pain NRS on vulvar cotton swab test improved from 6.1 ± 2.6 at baseline to 3.1 ± 2.6 (P < .001), and 74% of women (n = 26) reported symptom improvement. At 9–12 months follow-up 66% reported ongoing symptom improvement, with no significant difference to the control group of 32 women. Conclusion Microablative Er:YAG vulvovaginal LASER therapy appears safe and well accepted among vulvodynia patients, but there was no significant difference in symptom improvement compared to a control group.

Tài liệu tham khảo

Pukall, 2016, Vulvodynia: Definition, prevalence, impact, and pathophysiological factors, J Sex Med, 13, 291, 10.1016/j.jsxm.2015.12.021 Bornstein, 2016, 2015 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia, Obstet Gynecol, 127, 745, 10.1097/AOG.0000000000001359 Goldstein, 2016, Vulvodynia: Assessment and treatment, J Sex Med, 13, 572, 10.1016/j.jsxm.2016.01.020 Gambacciani, 2017, Laser therapy for the restoration of vaginal function, Maturitas, 99, 10, 10.1016/j.maturitas.2017.01.012 Pitsouni, 2017, Laser therapy for the genitourinary syndrome of menopause. A systematic review and meta-analysis, Maturitas, 103, 78, 10.1016/j.maturitas.2017.06.029 Preti, 2019, The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document, J Low Genit Tract Dis, 23, 151, 10.1097/LGT.0000000000000462 Murina, 2016, Fractional CO2 laser treatment of the vestibule for patients with vestibulodynia and genitourinary syndrome of menopause: A pilot study, J Sex Med, 13, 1915, 10.1016/j.jsxm.2016.10.006 Leclair, 2007, KTP-nd:YAG laser therapy for the treatment of vestibulodynia: A follow-up study, J Reprod Med, 52, 53 Schoenthaler, 2012, [The Freiburg Index of Patient Satisfaction: Introduction and validation of a new questionnaire], Dtsch Med Wochenschr, 137, 419 Tincello, 2013, Validation of the Patient Global Impression scales for use in detrusor overactivity: Secondary analysis of the RELAX study, Bjog, 120, 212, 10.1111/1471-0528.12069 Lev-Sagie, 2017, Low-level laser therapy for the treatment of provoked vestibulodynia-A randomized, placebo-controlled pilot trial, J Sex Med, 14, 1403, 10.1016/j.jsxm.2017.09.004 Miranda Varella, 2018, A systematic review of drug treatment of vulvodynia: Evidence of a strong placebo effect, Bjog, 125, 1216, 10.1111/1471-0528.15223
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Sexual Medicine

Tập 9

100432

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