S Athanasiou1, E Pitsouni1,2, S Antonopoulou3, D Zacharakis1, S Salvatore4, M E Falagas2,5,6, T Grigoriadis1. 1. a Urogynecology Unit, 1st Department of Obstetrics and Gynecology , "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece ; 2. b Alpha Institute of Biomedical Sciences (AIBS) , Athens , Greece ; 3. c Microbiology Department , "G. Gennimatas" General Hospital , Athens , Greece ; 4. d Obstetrics and Gynecology Unit , Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital , Milan , Italy Urogynecology Unit ; 5. e Department of Medicine-Infectious Diseases , IASO General Hospital , Athens , Greece ; 6. f Department of Medicine , Tufts University School of Medicine , Boston, MA , USA.
Abstract
OBJECTIVES: To assess the effect of microablative fractional CO2 laser (MFCO2-Laser) therapy on the vaginal microenvironment of postmenopausal women. METHODS: Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear <5%. Vaginal fluid pH values, fresh wet mount microscopy, Gram stain and aerobic and anaerobic cultures were evaluated at baseline and 1 month after each subsequent therapy. Nugent score and Hay-Ison criteria were used to evaluate vaginal flora. RESULTS: Fifty-three women (mean age 57.2 ± 5.4 years) participated and completed this study. MFCO2-Laser therapy increased Lactobacillus (p < 0.001) and normal flora (p < 0.001) after the completion of the therapeutic protocol, which decreased vaginal pH from a mean of 5.5 ± 0.8 (initial value) to 4.7 ± 0.5 (p < 0.001). The prevalence of Lactobacillus changed from 30% initially to 79% after the last treatment. Clinical signs and symptoms of bacterial vaginosis, aerobic vaginitis or candidiasis did not appear in any participant. CONCLUSION: MFCO2-Laser therapy is a promising treatment for improving the vaginal health of postmenopausal women by helping repopulate the vagina with normally existing Lactobacillus species and reconstituting the normal flora to premenopausal status.
OBJECTIVES: To assess the effect of microablative fractional CO2 laser (MFCO2-Laser) therapy on the vaginal microenvironment of postmenopausal women. METHODS: Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear <5%. Vaginal fluid pH values, fresh wet mount microscopy, Gram stain and aerobic and anaerobic cultures were evaluated at baseline and 1 month after each subsequent therapy. Nugent score and Hay-Ison criteria were used to evaluate vaginal flora. RESULTS: Fifty-three women (mean age 57.2 ± 5.4 years) participated and completed this study. MFCO2-Laser therapy increased Lactobacillus (p < 0.001) and normal flora (p < 0.001) after the completion of the therapeutic protocol, which decreased vaginal pH from a mean of 5.5 ± 0.8 (initial value) to 4.7 ± 0.5 (p < 0.001). The prevalence of Lactobacillus changed from 30% initially to 79% after the last treatment. Clinical signs and symptoms of bacterial vaginosis, aerobic vaginitis or candidiasis did not appear in any participant. CONCLUSION:MFCO2-Laser therapy is a promising treatment for improving the vaginal health of postmenopausal women by helping repopulate the vagina with normally existing Lactobacillus species and reconstituting the normal flora to premenopausal status.
Authors: Yona Tadir; Adrian Gaspar; Ahinoam Lev-Sagie; Macrene Alexiades; Red Alinsod; Alex Bader; Alberto Calligaro; Jorge A Elias; Marco Gambaciani; Jorge E Gaviria; Cheryl B Iglesia; Ksenija Selih-Martinec; Patricia L Mwesigwa; Urska B Ogrinc; Stefano Salvatore; Paolo Scollo; Nicola Zerbinati; John Stuart Nelson Journal: Lasers Surg Med Date: 2017-02-21 Impact factor: 4.025