MonaLisa Touch Research Articles

Fractional CO2 Laser in the Treatment of Post-Menopausal Vaginal Atrophy

Introduction: Similarly to other parts of the body, the vagina changes over time, and vaginal atrophy is a common condition in women between 45 and 55 years of age. It causes discomfort and psychological suffering, in addition to being the main cause of pain during sexual intercourse. Objective: This study aimed to evaluate the use of intravaginal fractional CO2 laser in the treatment of atrophy of the vaginal mucosa, as well as its effect on symptoms such as itching, irritation, pain, dyspareunia, urinary incontinence, dryness, and loss of mucosal elasticity. Methods: This is a prospective cohort of 14 menopausal women with vulvovaginal symptoms who were evaluated pre- and post-procedure with CO2 laser treatment using the Monalisa Touch® technique. Cytological examination and validated questionnaires were used in the assessment.

Fractional CO2 laser treatment effect on cervicovaginal lavage zinc and copper levels: a prospective cohort study

BackgroundThe basic principle of vaginal laser therapy is the rejuvenation of the affected tissue. Zinc and copper are essential nutritional trace elements and have a key role in connective tissue homeostasis. We aimed to investigate the effect of vaginal, fractional CO2 laser treatment on cervicovaginal lavage (CVL) zinc and copper levels.MethodsTwenty-nine postmenopausal women with symptoms of vaginal dryness were enrolled in our prospective cohort study. Three treatments with MonaLisa Touch CO2 laser system were performed four weeks apart. At each treatment CVL was collected, Vaginal Health Index (VHI) was obtained, and Visual Analog Scale (VAS) for vaginal dryness was assigned by patients. Zinc and copper concentrations were measured with optical emission spectrometry before each treatment and six weeks after the 3rd treatment.ResultsThe VHI scores significantly improved after each laser treatment (mean ± SD VHI score, 13.03 ± 4.49 before vs. 15.55 ± 4.35 after the 1st, 17.79 ± 4.57 after the 2nd and 19.38 ± 4.39 after the 3rd treatment, P < 0.01). Similarly, VAS scores reflected improvement (mean ± SD VAS score 6.59 ± 2.86 before vs. 4.17 ± 2.86 after the 1st, 2.45 ± 2.43 after the 2nd and 1.41 ± 1.94 after the 3rd treatment, P < 0.01). CVL zinc levels were significantly higher compared to copper levels (0.06 ± 0.04 vs. 0.006 ± 0.006 mg/L, P < 0.01) at baseline. While copper levels remained the same through treatments, the CVL zinc level was significantly higher after the second laser treatment compared to the baseline.ConclusionsFractional CO2 laser treatment of the vagina impacts CVL zinc and copper levels differently. While CVL copper levels were not different after each laser treatment, zinc levels were significantly higher after the second treatment before returning to baseline values.

Sexual Health in the Elderly Population.

Among the growing elderly population, sexual health remains an important concern for individuals and couples. An understanding of the expected changes with aging and taking care of aging men and women is important for treating sexual dysfunction. Sexual health issues related to aging can be both linked between men and women and independent. The aim of this study is to determine the most important considerations that contribute to sexual satisfaction in men and women in this population. Many factors contribute to the overall sexual health of men and women. Hypogonadism and erectile dysfunction both warrant thorough evaluation and consideration of treatment to improve sexual satisfaction. Underlying cardiovascular issues may be present in men presenting with these concerns. In addition to hormone replacement and traditional therapy for erectile dysfunction, therapeutic stem cell injection has shown some promise. Menopause, vaginal dryness, and dyspareunia play important roles in sexual satisfaction in women. Vaginal moisturizers, topical estrogen, and MonaLisa Touch laser therapy all may aid in improving these symptoms and ultimately sex lives. Studies have also demonstrated some benefit in populations with arousal disorders, which can be present in the elderly. Male patients often describe issues related to erectile dysfunction and hypogonadism, and issues with sexual drive. The pathophysiology is linked between these conditions and treatment of one component can provide symptom relief on a larger scale. A combination of testosterone therapy, lifestyle modifications, and therapy for erectile dysfunction relates to sexual satisfaction in men. In women, an understanding of the physiological process of menopause and offering therapy when indicated can improve the quality of sexual health and provide satisfaction to both patient and partner. While aging can diminish drive and desire, proper counseling and treatment may significantly benefit some patients. A multimodal approach involving the physician, patient, and partner will optimize care and may improve the quality of life in the elderly. This review outlines some normal changes due to aging and identifies some current treatment options for a population in which sexual health can be often ignored or dismissed. By understanding the available tools, a more comprehensive approach can be taken to achieve satisfaction in couples and individuals alike.

004 Safety and Efficacy of CO2 Fractional Laser Therapy in Women with Vestibulodynia

CO2 fractional laser (MonaLisa Touch) has traditionally been used to treat menopausal women with vaginal atrophy. Pain often emanates from the vestibule in both pre- and post-menopausal women. Using the CO2 fractional laser with a vestibular probe has been found clinically to be useful for treatment of vestibulodynia.

Fractional CO2 Laser for Treatment of Vulvovaginal Atrophy: A Short Time Follow-up.

Objective: The aim of this study was to evaluate the safety and efficacy of fractional CO2 laser for treatment of vulvovaginal atrophy. Materials and methods: In this clinical trial study, we evaluated the laser effect on vulvovaginal atrophy in 47 women aged 43-80 years. Each woman was treated with fractional CO2 laser, SmartXide2V2LR, DEKA, Monalisa Touch, vaginal 360o probe and cosmetic probe. The severity of vulvovaginal atrophy symptoms was evaluated before first session of laser and every 4 weeks after laser treatment until 12 weeks. Adverse effects including pain and itching were assessed at all visits. The statistical analysis was performed using SPSS version 23. Results: The response to laser therapy for vaginal dryness was significantly (p <0.001) improved. Also, the response to laser therapy for each symptom include dyspareunia, vaginal discharge, itching and urge urinary incontinence was statistically significant (p <0.001) based on visual analogue scale (VAS). Conclusion: It seems vaginal fractional CO2 laser can be applied as an effective and safe treatment method in genitourinary syndrome of menopause (GSM). It is necessary to conduct studies with long-term follow-up.

019 Safety and Efficacy of CO2 Fractional Laser Therapy in Women with Vestibulodynia

CO2 fractional laser (MonaLisa Touch) has been used traditionally for the treatment of vaginal atrophy in menopausal women. Pain often emanates from the vestibule in both pre- and post-menopausal women. CO2 fractional laser via a vestibular probe has been found clinically useful for the treatment of vestibulodynia in a pilot study. A 3-site, prospective, double-blind, sham-controlled investigator-initiated research study was performed to further examine the safety and efficacy of CO2 fractional laser delivery in women with vestibulodynia. Subjects meeting inclusion and exclusion criteria were randomized to active or sham treatment 2:1. Changes were assessed on multiple outcome measures, including cotton swab test at 1:00, 3:00, 5:00, 6:00, 7:00, 9:00 and 11:00 positions, Female Sexual Function Index (FSFI) pain domain and total score, Female Sexual Distress Score (FSDS-R), and O’Leary/Sant Voiding and Pain Indices (ICSI/ICPI). In addition, vulvoscopic photography was performed at screening and at the last visit. Photographs were blinded and examined by an independent reviewer for 10 parameters of health of the vulva, vestibule, urethral meatus and vagina. Each arm consisted of 3 treatments 4 weeks apart (weeks 0 – 8). Follow-up visits were completed at weeks 12 and 16. Subjects assigned to sham were crossed over to active treatment at 12 weeks, starting the first of 3 active treatment sessions on that visit with follow-up.

2053 the Fractional CO2 Laser in Korea: An Effective Treatment Option for Genitourinary Syndrome of Menopause

Study Objective The genitourinary syndrome of menopause (GSM) is associated with bothersome symptoms in menopausal women. The GSM may have a negative impact on the quality of life of postmenopausal women, and it should be treated with an appropriate therapy. This study is aimed to evaluate the efficacy of fractional CO2 laser therapy (Laser therapy) in the treatment of GSM. Design GSM patients treated with Laser therapy and evaluates the progress before and after treatment using objective and subjective indicators. Setting We use the fractional CO2 laser (SmartXide2 V2LR, Monalisa Touch, DEKA, Italy). The therapy was applicated every 4 weeks. Patients or Participants The total of 38 women presenting with GSM were enrolled to Laser therapy. 22 patients are survivors of breast cancer. Interventions The severity of symptoms was assessed with a visual analog scale(VAS) at the baseline and every visit. We also measured the objective scale using the vaginal health index score (VHIS) at baseline and after completion of laser procedure. At each procedure, patient's pain in VAS and the physician's difficulty was recorded at each time. At last visit, the patients evaluate their satisfaction with the laser therapy using a 5 points Likert scale. Measurements and Main Results In our study, almost all symptoms showed the mean VAS score improvement. But only the relief in vaginal dryness improved significantly(p Conclusion This study shows that fractional CO2 laser treatment is effective in patients who suffering from genitourinary syndrome of menopause. Further studies should be performed to confirm the results and to assess the long-term effects of the laser therapy.

PD20-08 SAFETY AND EFFICACY OF CO 2 FRACTIONAL LASER THERAPY IN WOMEN WITH VESTIBULODYNIA: AN INTERIM ANALYSIS

INTRODUCTION AND OBJECTIVES:CO2 fractional laser (MonaLisa Touch) for treatment of vestibulodynia via a vestibular probe has been found clinically useful in a pilot study. A 3-site, prospective, do...

Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause

ObjectivesTo evaluate the safety and long-term efficacy of fractional CO2 laser treatment in reducing the severity of symptoms of genitourinary syndrome of menopause (GSM) in menopausal women. Study design102 women presenting with symptomatic GSM were treated with the fractional CO2 laser (MonaLisa Touch, DEKA) system across a series of treatments delivered at intervals of six or more weeks. The Australian Pelvic Floor Questionnaire was used to gather data on sexual function and side-effects at three time-points across the study period (prospective panel design study). Wilcoxon signed-rank tests were used to detect statistically and clinically significant changes in sexual function and side-effects occurring from pre- to post-treatment. The primary outcome of this study was an improvement of the symptoms of GSM. The secondary outcome included bladder function and prolapse symptoms. ResultsA total of 102 women suffering from moderate to severe GSM were recruited. Eighty-four percent experienced significant improvement in their symptoms after CO2 laser treatment. Scores on measures of sexual function, dyspareunia, and bothersomeness of sexual issues were improved from pre-treatment to long-term (12–24 month) follow-up. Furthermore, there were improvements on measures of bladder function (P=0.001), prolapse (P=0.001), vaginal sensation (P=0.001), vaginal lubrication (P<0.001) and urge incontinence (P=0.003) from the pre-treatment assessment to the second assessment (i.e. after the third treatment). ConclusionsIn this study, fractional microablative CO2 laser treatment was associated with an improvement in symptoms of GSM and sexual function.

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Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy

Objective To investigate the effects of fractional microablative CO 2 laser on sexual function and overall satisfaction with sexual life in postmenopausal women with vulvovaginal atrophy (VVA). Method This prospective study included 77 postmenopausal women (mean age 60.6 6.2 years) treated for VVA symptoms with the fractional microablative CO 2 laser system (SmartXide 2 V 2 LR, Monalisa Touch, DEKA, Florence, Italy). Sexual function and quality of life were evaluated with the Female Sexual Function Index (FSFI) and the Short Form 12 (SF-12), respectively, both at baseline and at 12-week follow-up. A 10-mm visual analog scale was used to measure the overall satisfaction with sexual life and the intensity of VVA symptoms (vaginal burning, vaginal itching, vaginal dryness, dyspareunia and dysuria) before and after the study period. Results We observed a signifi cant improvement in the total score and the scores in each specifi c domain of the FSFI at 12-week follow-up compared to baseline ( p 0.001). After concluding the laser treatment, the overall satisfaction with sexual life signifi cantly improved ( p 0.001). Seventeen (85%) out of 20 (26%) women, not sexually active because of VVA severity at baseline, regained a normal sexual life at the 12-week follow-up. Finally, we also found a signifi cant improvement in each VVA symptom ( p 0.001) and in quality-of-life evaluation, both for the scores in the physical ( p 0.013) and mental ( p 0.002) domains. Conclusions Fractional microablative CO 2 laser treatment is associated with a signifi cant improvement of sexual function and satisfaction with sexual life in postmenopausal women with VVA symptoms.

Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy

Objective To investigate the effects of fractional microablative CO2 laser on sexual function and overall satisfaction with sexual life in postmenopausal women with vulvovaginal atrophy (VVA).Method This prospective study included 77 postmenopausal women (mean age 60.6 ± 6.2 years) treated for VVA symptoms with the fractional microablative CO2 laser system (SmartXide2 V2LR, Monalisa Touch, DEKA, Florence, Italy). Sexual function and quality of life were evaluated with the Female Sexual Function Index (FSFI) and the Short Form 12 (SF-12), respectively, both at baseline and at 12-week follow-up. A 10-mm visual analog scale was used to measure the overall satisfaction with sexual life and the intensity of VVA symptoms (vaginal burning, vaginal itching, vaginal dryness, dyspareunia and dysuria) before and after the study period.Results We observed a significant improvement in the total score and the scores in each specific domain of the FSFI at 12-week follow-up compared to baseline (p < 0.001). After concluding the laser treatment, the overall satisfaction with sexual life significantly improved (p < 0.001). Seventeen (85%) out of 20 (26%) women, not sexually active because of VVA severity at baseline, regained a normal sexual life at the 12-week follow-up. Finally, we also found a significant improvement in each VVA symptom (p < 0.001) and in quality-of-life evaluation, both for the scores in the physical (p = 0.013) and mental (p = 0.002) domains.Conclusions Fractional microablative CO2 laser treatment is associated with a significant improvement of sexual function and satisfaction with sexual life in postmenopausal women with VVA symptoms.