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Laser and genitourinary syndrome of menopause

Jadwiga Wańczyk-Baszak, Sławomir Woźniak, Bartosz Milejski, Tomasz Paszkowski
Perimenopausal changes caused by oestrogen deficiency are accompanied by a decrease in the content of collagen and elastin in the tissues, leading to thinning of the epithelium and the resultant disappearance of the superficial layer, which leads to smooth muscle dysfunction as well as connective tissue degradation. This aetiopathogenetic chain results in a set of symptoms experienced by approximately 50% of women in the peri- and postmenopausal period. Symptoms of dryness, burning, dyspareunia and urgency contribute to a significant reduction in the quality of sexual function and general comfort of life due to recurrent infections of the vagina, vulva and urinary tract...
December 2018: Przeglad Menopauzalny, Menopause Review
C Ratz
BACKGROUND: Use of vaginal laser therapy in the treatment of grade I stress urinary incontinence and genitourinary syndrome of menopause is gaining in importance across the globe. MATERIALS AND METHODS: On the basis of the research that is currently available, an analysis is carried out regarding whether laser therapy is already suitable for use in the field of urology. RESULTS: The research available is still limited: randomized controlled studies in particular are lacking...
February 5, 2019: Der Urologe. Ausg. A
R Flint, L Cardozo, T Grigoriadis, A Rantell, E Pitsouni, S Athanasiou
Genitourinary syndrome of menopause (GSM) is a common condition affecting up to 50% of postmenopausal women and up to 70% of postmenopausal breast cancer survivors. GSM is a chronic condition with a significant impact on sexual health and quality of life. The mainstay of treatment has been with symptomatic relief using topical emollients or lubricants. Second-line treatment is with topical vaginal estrogens to restore the physiology of the vaginal epithelium. For some, the latter is not suitable or acceptable...
January 24, 2019: Climacteric: the Journal of the International Menopause Society
Catherine Gordon, Savanah Gonzales, Michael L Krychman
OBJECTIVE: The treatment of genitourinary syndrome of menopause (GSM) includes prescription hormone therapy, nonhormonal over-the-counter products, and most recently, laser treatment. Although the Food and Drug Administration has cleared fractional carbon dioxide (CO2) laser for a variety of dermatologic and gynecologic indications, lasers have not to date, been approved for use for vulvar/vaginal atrophy, or sexual dysfunction. METHODS: Four case studies that were referred to a tertiary sexual medicine center regarding laser treatment complications for GSM are reported...
January 14, 2019: Menopause: the Journal of the North American Menopause Society
Olivia H Chang, Marie Fidela R Paraiso
Genitourinary syndrome of menopause is defined as the collection of signs and symptoms of the genitourinary tract from menopause, previously known as vulvovaginal atrophy. The Food and Drug Administration (FDA) has approved select hormonal and non-hormonal treatment for vaginal atrophy, including systemic estrogen, vaginal estrogen, estrogen receptor modulators and dehydroepiandrosterone. These medications can increase the risk of thromboembolic disease and malignancy; furthermore, the cost of the medications have been increasing...
December 23, 2018: American Journal of Obstetrics and Gynecology
S Abbas Shobeiri, M H Kerkhof, Vatche A Minassian, Tony Bazi
This committee opinion reviews the laser-based vaginal devices for treatment of genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence. The United States Food and Drug Administration has issued a warning for unsubstantiated advertising and use of energy-based devices. Well-designed case-control studies are required to further investigate the potential benefits, harm, and efficacy of laser therapy in the treatment of genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence...
December 6, 2018: International Urogynecology Journal
Macrene Alexiades
Genitourinary syndrome of menopause (GSM), encompassing the disorders of atrophic vaginitis, urinary incontinence, and pelvic prolapse, affects the majority of postmenopausal women, as well as patients who are undergoing breast cancer treatement, post-ovarectomy, post-radiation, and breast-feeding. There is a need for better treatment options for these common conditions that adversely affect physical function and quality of life and that are often underserved by existing options. Lasers have been used to treat genitourinary tissue for over 40 years, and over the past decade, several lasers and radiofrequency devices have been developed and clinically tested for the treatment of GSM, with an accumulating body of evidence demonstrating their safety and efficacy...
December 2018: Seminars in Cutaneous Medicine and Surgery
Anthony V Benedetto
Topical silicone gel is more beneficial than petrolatum-based products as an all-purpose wound dressing for granulating and sutured wounds, regardless of cause. Vaginal laser rejuvenation is effective in relieving genitourinary syndrome of menopause, stress urinary incontinence, vaginal relaxation syndrome, and related vulvar disorders. New cosmetic indications in the upper face for onabotulinumtoxinA have been approved by the Food and Drug Administration, whereas off-label treatments in the lower face increase in popularity...
January 2019: Dermatologic Clinics
Stavros Athanasiou, Eleni Pitsouni, Themos Grigoriadis, Dimitris Zacharakis, Matthew E Falagas, Stefano Salvatore, Athanasios Protopapas, Dimitris Loutradis
OBJECTIVE: The aim of this study is to assess the efficacy of microablative fractional CO2 laser therapy for genitourinary syndrome of menopause (GSM) management, when three, four, or five laser therapies were applied in a follow-up period of 12 months. METHODS: Retrospective study evaluating GSM symptoms at baseline, and 1, 3, 6, and 12 months after last laser therapy. Visual analog scale, International Consultation on Incontinence Questionnaires- Female Urinary Tract Symptoms, International Consultation on Incontinence Questionnaires-Urinary Incontinence Short Form, Urogenital Distress Inventory-6, and Female Sexual Function Index were used for assessment of GSM symptoms' intensity or bothering and parameters of sexual function...
September 24, 2018: Menopause: the Journal of the North American Menopause Society
I Jardin, G Canlorbe, J-L Mergui, M Nikpayam, J Belghiti, C Uzan, H Azaïs
Genitourinary syndrome of menopause (GSM) brings together a collection of signs including vaginal dryness, burning sensation and itching discomfort as well as deterioration of sexual health, dysuria, urgenturia and repeated urinary infections and may be responsible for a significant impairment of quality of life in symptomatic postmenopausal women. The management of GSM therefore represents a public health issue. Systemic or local hormonal treatments are frequently offered, as well as non-hormonal treatments...
November 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Anke R Mothes, Marion Runnebaum, Ingo B Runnebaum
OBJECTIVES: To evaluate a dual-phase protocol for vaginal ablative Erbium:YAG laser treatment in pelvic floor medicine. STUDY DESIGN: Data from consecutive patients undergoing vaginal Erbium:YAG laser for first-degree pelvic floor complaints at a certified university urogynecological unit were analyzed. Fractional ablative and thermal treatment with adjustable pulse duration, fluence, and pulse interval was performed in single ten-minute treatment course. Followed up interval was 6 weeks including interviews on expectations, goal setting, goal achievement, and satisfaction (EGGS), vaginal pH, and determination of the Gloria-Bachmann-Index (VHI)...
October 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Y-Y Liu, K-L Lin, C-Y Long
No abstract text is available yet for this article.
October 2018: Climacteric: the Journal of the International Menopause Society
Andrew Rabley, Tina O'Shea, Russell Terry, Sharon Byun, M Louis Moy
PURPOSE OF REVIEW: The purpose of this article is to review the available data regarding the application and therapeutic outcomes of laser therapy for the treatment of genitourinary syndrome of menopause (GSM). RECENT FINDINGS: There have been several studies regarding the use of laser therapy for the treatment of GSM. Most of these studies show a trend toward safe and effective treatment in the short term (less than or equal to 12 weeks). However, these studies are lacking in randomization, blinding, placebo, and comparison groups...
August 17, 2018: Current Urology Reports
Eleni Pitsouni, Themos Grigoriadis, Athanasios Douskos, Margarita Kyriakidou, Matthew E Falagas, Stavros Athanasiou
Genitourinary syndrome of menopause (GSM) increases the probability of female sexual dysfunction (FSD). The aim of the current study is to systematically assess data regarding sexual function and use of vaginal therapies, alternative to vaginal estrogens (VE), in menopausal women with GSM. PubMed, Scopus and Cochrane Library were searched (May-September 2017) using combination keywords: "dyspareunia and vaginal therapy", "sexual function and vaginal therapy", "orgasm and vaginal therapy", "vaginal atrophy" and "genitourinary syndrome of menopause"...
October 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jens-Erik Walter, Annick Larochelle
OBJECTIVE: This technical bulletin reviews the evidence relating to risks and benefits of using intravaginal laser technology in the management of genitourinary syndrome of menopause and stress urinary incontinence. INTENDED USERS: Gynaecologists, urogynaecologists, urologists, and other health care professionals who assess, counsel, and provide care for women with genitourinary syndrome of menopause and stress urinary incontinence. TARGET POPULATION: Adult women with genitourinary syndrome of menopause and stress urinary incontinence seeking complementary or alternative treatment options to topical estrogen, non-hormonal vaginal moisturizers, physiotherapy, intravaginal devices, and surgery...
April 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Adrian Gaspar, Sandra Maestri, Joaquin Silva, Hugo Brandi, Daniel Luque, Neža Koron, Zdenko Vižintin
OBJECTIVES: Genitourinary syndrome of menopause (GSM) combines the conditions of vulvovaginal atrophy (VVA) and urinary tract dysfunction, which is a result of urethral atrophy. There are several treatment methods available for the management of vulvovaginal symptoms of GSM, whereas urinary tract dysfunction often remains overlooked and undertreated. The objective of this pilot study was to assess the safety and efficacy of intraurethral Er:YAG laser treatment of urinary symptoms of GSM...
October 2018: Lasers in Surgery and Medicine
Angelamaria Becorpi, Giuseppina Campisciano, Nunzia Zanotta, Zelinda Tredici, Secondo Guaschino, Felice Petraglia, Annalisa Pieralli, Giovanni Sisti, Francesco De Seta, Manola Comar
The composition of vaginal microbiome in menopause and cancer survivor women changes dramatically leading to genitourinary syndrome of menopause (GSM) in up to 70% of patients. Recent reports suggest that laser therapy may be valuable as a not hormonal therapeutic modality. The aim of the present study was to evaluate the effects of fractional CO2 laser treatment on the vaginal secretory pathway of a large panel of immune mediators, usually implicated in tissue remodeling and inflammation, and on microbiome composition in postmenopausal breast cancer survivors...
July 2018: Lasers in Medical Science
A R Mothes, M Runnebaum, I B Runnebaum
PURPOSE: First evaluation of dual-phase vaginal Er:YAG laser to omit hormonal treatment for atrophy-related symptoms in post-menopausal breast cancer survivors following prolapse surgery. METHODS: Patients with a history of breast cancer at the time of surgery for pelvic organ prolapse were offered non-hormonal vaginal Er:YAG laser treatment when complaining of atrophy-related genitourinary syndrome of menopause. A single 10-min course of dual-phase protocol of pulsed Er:YAG laser (2940 nm, fractional ablative and thermal mode, fluence according to tissue thickness)...
May 2018: Journal of Cancer Research and Clinical Oncology
M Gambacciani, M Levancini, E Russo, L Vacca, T Simoncini, M Cervigni
OBJECTIVES: To evaluate the long-term efficacy of a second generation of vaginal laser treatment, the vaginal erbium laser, as a non-ablative photothermal therapy for the management of genitourinary syndrome of menopause. METHODS: The study was performed using an erbium laser crystal yttrium-aluminum-garnet (XS Fotona Smooth™, Fotona, Ljubljana, Slovenia) with a wavelength of 2940 nm. Postmenopausal women (n = 205) were treated with three laser applications at 30-day intervals...
April 2018: Climacteric: the Journal of the International Menopause Society
Lauren F Streicher
Many healthcare providers are offering women treatment with the fractionated CO2 laser for a myriad of gynecologic issues, including genitourinary syndrome of menopause (GSM). Because existing data are limited, providing guidance is challenging. This Practice Pearl addresses what we know and don't know about the use of the fractionated CO2 laser for the treatment of GSM.
May 2018: Menopause: the Journal of the North American Menopause Society
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