Fractional CO2 Laser Treatment for Vaginal Rejuvenation in Post-Menopausal Indian Women

Abstract

Background Laser vaginal rejuvenation is a minimally invasive fractional carbon dioxide (CO2) laser procedure for the woman with vulvovaginal atrophy (VVA), vaginal laxity and for the enhancement of sexual functioning. It has also been proposed for the woman with urge and stress urinary incontinence. CO2 stimulates collagen/elastin contraction, neocollagenesis, and neovascularization. Aim To study the efficacy of CO2 laser in the improvement of VVA, stress urinary incontinence, urge incontinence and sexual functioning. Materials and Methods Twenty-six patients who were in the menopausal transition to post-menopausal age group who presented with any one of the above-mentioned complaints were enrolled in our study. Prior to the treatment, a vaginal examination was performed to ensure patients’ eligibility for the treatment and to determine the vaginal health index score (VHIS), subjective evaluation of VVA symptoms was provided using the visual analog scale (VAS) and the vaginal tightening and patients’ satisfaction were assessed. They also took a questionnaire regarding their sexual functioning. They underwent 3 sessions of CO2 laser with a 1-month interval. Results Significant improvement in VVA was noted after 12-weeks which was observed in vaginal elasticity, fluid volume, epithelial integrity, and patients noted the reduced intensity of vaginal symptoms, such as vaginal burning, dryness, itching, and dyspareunia which was confirmed by improvement in VHIS and VAS. There was a subjective improvement in some patients for stress urinary incontinence (SUI) and user interface (UI) as per patient feedback. Patients also noted a significant improvement in quality of life (QoL) and sexual functioning as there were improvement in female sexual function index (FSFI) and domain scores (i.e., desire, arousal, lubrication, pain, orgasm, satisfaction). Conclusion Fractional CO2 laser treatment definitely improved symptoms associated with VVA, stress and urge urinary incontinence, sexual functioning and overall QoL. Although various parameters and long-term results are yet to be noted, the treatment gives satisfying, non-surgical, out-patient, non-hormonal treatment for vaginal health.