Can pelvic organ prolapse in postmenopausal women be treated with laser therapy?. (2nd January 2021)

• Record Type: Journal Article
• Authors: Athanasiou, S.; Pitsouni, E.; Cardozo, L.; Zacharakis, D.; Petrakis, E.; Loutradis, D.; Grigoriadis, T.
• Is Part Of: Climacteric. Volume 24:Number 1(2021)
• Page Start: 101
• Page End: 106
• Publication Date: 2021-01-02
• Subjects: Cystocele -- rectocele -- intravaginal treatment -- menopause -- vaginal relaxation syndrome -- energy-based devices; Menopause -- Periodicals; Menopause -- Hormone therapy -- Periodicals; Menopause -- Periodicals; Estrogen Replacement Therapy -- Periodicals; Gynecology -- Periodicals; Societies, Medical -- Periodicals; 612.665
• DOI: 10.1080/13697137.2020.1789092
• Languages: English
• ISSNs: 1369-7137

Abstract

Abstract: Purpose: 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. Methods: 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. Results: 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. Conclusions: The findings of this study do not support use of the intravaginal Er:YAG laser for treatment of the anterior/posterior vaginal wall. Clinical trial identification number: NCT03714607