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Purpose: This study aimed to clarify the efficacy of intravaginal CO2-laser treatment in postmenopausal women with genitourinary syndrome of menopause (GSM). Materials and methods: This double-blind, randomized, sham-controlled trial included postmenopausal women diagnosed with GSM and bothersome dryness and dyspareunia. Treatment consisted of three sessions. Active CO2-laser treatments (active group) were compared to sham treatments (sham group) with the primary endpoints being changes in dryness and dyspareunia intensity, as assessed by the 10-cm visual analog scale. Secondary endpoints were as follows: changes in Female Sexual Function Index (FSFI; total score and all domains), itching, burning, dysuria, and Urogenital Distress Inventory (UDI-6); incidence of symptoms; and presence of adverse events. All outcomes were evaluated at baseline and 4 months post baseline. Results: Fifty-eight women (28 in the active group and 30 in the sham group) were eligible for inclusion. In the active group, dryness, dyspareunia, FSFI (total score), itching, burning, dysuria, and UDI-6 were significantly improved (mean [standard deviation] –5.6 [2.8], −6 [2.6], 12.3 [8.9], −2.9 [2.8], −2.3 [2.8], −0.9 [2.1], and −8.0 [15.3], respectively). In the sham group, dryness, itching, and burning were significantly improved (–1.9 [2], −1.4 [1.9], and −1 [1.9], respectively). All changes were in favor of the active group. After completion of the protocol, the proportion of participants with dryness, dyspareunia, and sexual dysfunction was significantly lower in the active group compared to those in the sham group (all p < 0.005). Conclusions: CO2 laser could be proposed as an effective alternative treatment for the management of GSM as it is superior to sham treatments.

This study aims to assess the effectiveness of the non-ablative photothermal erbium laser (Er:YAG laser) for managing anterior and/or posterior vaginal compartment prolapse.A randomized, single-blind, 1:1 trial was performed comparing Er:YAG laser treatment to watchful waiting in postmenopausal women with symptomatic cystocele and/or rectocele stage 2 or 3 who opted to undergo surgery due to bothersome prolapse symptoms. Three Er:YAG laser treatments at monthly intervals were applied for the Er:YAG laser group, while there was no treatment for the watchful-waiting group. The primary outcome was the proportion of patients with stage 0 or 1 following laser treatment, while secondary outcomes included the Pelvic Organ Prolapse Quantification System (POP-Q points), Pelvic Floor Distress Inventory Questionnaire short-form, Pelvic Floor Impact Questionnaire short-form, and Patients Global Impression of Improvement (PGI-I). All outcomes were evaluated at baseline and 4 months post baseline.Thirty women (15 vs. 15) were eligible to be included. No participants (0%) in either group had POP-Q stage 0 or 1 at 4 months. Moreover, no change was present in the secondary outcomes. In the PGI-I, 2/15 (14%) and 0/15 (0%) participants declared much better/very much better in the laser and watchful-waiting group, respectively.The findings of this study do not support use of the intravaginal Er:YAG laser for treatment of the anterior/posterior vaginal wall.

Objectives: Sexual dysfunction and radiation cystitis are common adverse events following radiotherapy for gynecological cancer (GC). This study aims to assess the efficacy of intravaginal ...

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 ...

Pelvic floor disorders (PFDs) are a common and complex problem encompassing a broad spectrum of conditions such as urinary incontinence, voiding difficulties, pelvic organ prolapse, anal incontinence, and chronic pelvic pain. The initial assessment of women with PFDs is based on a detailed and focused history and a holistic clinical evaluation of the pelvic floor. Other investigations may be used in clinical practice for the determination of the pathophysiology and the severity of the PFDs. In the field of urogynecology, urodynamic studies, ultrasound, and magnetic resonance imaging of the pelvic floor are currently implemented in the diagnostic work-up of women with PFDs. These provide valuable information not only on the anatomic integrity but also on the function of the pelvic floor which may not be apparent from the clinical examination. The provision of such information is complementary to the patient's symptoms and degree of bother and enables the implementation of a targeted treatment plan, thus maximizing the likelihood of cure and minimizing the risk of treatment complications.

Objectives: To assess the effect of microablative fractional CO 2 laser (MFCO 2 -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

The objective of this prospective study was to evaluate the effectiveness of day-case Cavaterm plus thermal balloon endometrial ablation in the treatment of therapy-resistant menorrhagia. The study included 220 patients with a mean age of 41 years, mean parity of 2.1 and mean duration of menorrhagia of 3.2 years. A 6-mm diameter Cavaterm plus catheter with a silicone balloon at its tip was used. The ablation time was 10 minutes at a temperature of 78 degrees C. No procedure-related operative or immediate postoperative complications were encountered. The mean follow-up period was 19 months (range 6-24 months). The amenorrhoea-hypomenorrhoea rates at the various follow-up periods ranged between 74% and 83%. At the end of follow-up, 83% of patients were satisfied with the procedure. We conclude that Cavaterm plus is a safe and effective treatment for menorrhagia and has good patient acceptability.