Safety and long-term efficacy of fractional CO 2 laser treatment in women suffering from genitourinary syndrome of menopause

Objectives To evaluate the safety and long-term efficacy of fractional CO 2 laser treatment in reducing the severity of symptoms of genitourinary syndrome of menopause (GSM) in menopausal women. Study design 102 women presenting with symptomatic GSM were treated with the fractional CO 2 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. Results A total of 102 women suffering from moderate to severe GSM were recruited. Eighty-four percent experienced significant improvement in their symptoms after CO 2 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). Conclusions In this study, fractional microablative CO 2 laser treatment was associated with an improvement in symptoms of GSM and sexual function.