Skip to main content

Advertisement

Log in

Fractional CO2 laser for vulvovaginal atrophy (VVA) dyspareunia relief in breast cancer survivors

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the efficacy of fractional CO2 laser therapy in breast cancer survivors as a therapeutic method for vulvovaginal atrophy (VVA) dyspareunia.

Methods

50 patients (mean age 53.3 years) underwent fractional microablative CO2 laser treatment for dyspareunia in oncological menopause (mean time of menopause 6.6 years). The Gloria Bachmann’s Vaginal Health Index (VHI) score was chosen as system to evaluate the presence of VVA and its improvement after the treatment. Intensity of dyspareunia was evaluated using a visual analog scale (VAS).

Results

Data indicated a significant improvement in VVA dyspareunia (p < 1.86e−22) in breast cancer survivors who had undergone 3 sessions of vaginal fractional CO2 laser treatment. Moreover, VHI scores were significantly higher 30 days post-treatment (T4) (p < 0.0001). 76 % of patients were satisfied or very satisfied with the treatment results. The majority (52 %) of patients were satisfied after a long-term follow-up (mean time 11 months). No adverse events due to fractional CO2 laser treatment occurred.

Conclusions

The treatment with fractionated CO2 laser appeared to be a feasible and effective treatment for VVA dyspareunia in breast cancer survivors with contraindications to hormonal treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Nappi RE, Palacios S (2014) Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climateric 17:3–9

    Article  CAS  Google Scholar 

  2. Santoro N, Komi J (2009) Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med 6:2133–2142

    Article  PubMed  Google Scholar 

  3. The North American Menopause Society. Management of symptomatic vulvovaginal atrophy (2013) 2013 position statement of The North American Menopause Society. Menopause 20:888–902

    Article  Google Scholar 

  4. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ (2007) A study of sexuality and health among older adults in the United States. N Engl J Med 357:762–774

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sturdee DW, Panay N (2010) International Menopause Society Writing Group. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric 13:509–522

    Article  CAS  PubMed  Google Scholar 

  6. Perino A, Calligaro A, Forlani F, Tiberio C, Cucinella G, Svelato A, Saitta S, Calagna G (2015) Vulvo-vaginalatrophy: a new treatment modality using thermo-ablative fractional CO2 laser. Maturitas 80:296–301

    Article  PubMed  Google Scholar 

  7. Salvatore S, Nappi RE, Zerbinati N, Calligaro A, Ferrero S, Origoni M, Candiani M, Leone Roberti Maggiore U (2014) A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climateri 17:363–369

  8. Committee on Gynecologic Practice, American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 378 (2007) Vaginal “rejuvenation” and cosmetic vaginal procedures. Obstet Gynecol 110:737–738

  9. Panda S, Das A, Singh AS, Pala S (2014) Vaginal pH: a marker for menopause. J Midlife Health 5:34–37

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Moradan S, Ghorbani R, Nasiri Z (2010) Can vaginal pH predict menopause? Saudi Med J 31:253–256

    PubMed  Google Scholar 

  11. Persu C, Chapple CR, Cauni, V, Gutue S, Geavlete P (2011) Pelvic organ prolapse quantification system (POP–Q)—a new era in pelvic prolapsed staging. J Med Life 75–81

  12. Bachmann GA, Notevolitz M, Kelly SL (1992) Long-term non-hormonal treatment of vaginal dryness. Clin Pract Sex 8:3–8

    Google Scholar 

  13. Wysocki S, Kingsberg S, Krychman M (2014) Management of vaginal atrophy: implications from the Revive survey. Clin Med Insights Reprod Health 8:23–30

    Article  PubMed  PubMed Central  Google Scholar 

  14. Constantine G, Graham S, Koltun WD, Kingsberg SA (2014) Assessment of ospemifene or lubricants on clinical signs of VVA. J Sex Med 11:1033–1041

    Article  CAS  PubMed  Google Scholar 

  15. Portman D, Palacios S, Nappi RE, Mueck AO (2014) Ospemifene, a non-oestrogen selective oestrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: a randomised, placebo-controlled, phase III trial. Maturitas 78:91–98

    Article  CAS  PubMed  Google Scholar 

  16. Gaspar A, Addamo G, Brandi H (2011) Vaginal fractional CO2 laser: a minimally invasive option for vaginal rejuvenation. Am J Cosm Surg 28:156–162

  17. Zerbinati N, Serati M, Origoni M, Candiani M, Iannitti T, Salvatore S, Marotta F, Calligaro A (2015) Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. Lasers Med Sci 30:429–436

    Article  PubMed  Google Scholar 

  18. Salvatore S, Nappi RE, Parma M, Chionna R, Lagona F, Zerbinati N, Ferrero S, Origoni M, Candiani M, Leone Roberti Maggiore U (2015) Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. Climacteric 18:219–225

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank DEKA M.E.L.A. S.r.l. for technical support.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annalisa Pieralli.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pieralli, A., Fallani, M.G., Becorpi, A. et al. Fractional CO2 laser for vulvovaginal atrophy (VVA) dyspareunia relief in breast cancer survivors. Arch Gynecol Obstet 294, 841–846 (2016). https://doi.org/10.1007/s00404-016-4118-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-016-4118-6

Keywords

Navigation