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Curr Oncol 2022 05 23;29(5):3770-3779. Epub 2022 May 23.

Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan.

Although laser vaporization is a popular minimally invasive treatment for cervical intraepithelial neoplasia (CIN), factors influencing CIN recurrence are understudied. Moreover, the effect of surgeon volume on patients' prognosis after laser vaporization for CIN is unknown. This single-center retrospective study evaluated the predictive value of surgeon volume and patient characteristics for laser vaporization outcomes in women with pathologically confirmed CIN2. Read More

Medicina (Kaunas) 2022 Apr 4;58(4). Epub 2022 Apr 4.

Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, 21100 Varese, Italy.

: Insufficient connective urethra and bladder support related to childbirth and menopausal estrogen decrease leads to stress urinary incontinence (SUI). The aim of this review is to narratively report the efficacy and safety of new mini-invasive solutions for SUI treatment as laser energy devices, in particular, the microablative fractional carbon dioxide laser and the non-ablative Erbium-YAG laser. For this narrative review, a search of literature from PubMed and EMBASE was performed to evaluate the relevant studies and was limited to English language articles, published from January 2015 to February 2022. Read More

J Sex Med 2022 05 31;19(5):761-770. Epub 2022 Mar 31.

Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Center for Applied Biomedical Research, Department of Surgical and Medical Sciences, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy. Electronic address:

Background: Among treatments for vulvo-vaginal atrophy (VVA), there is a new kind of energy-based device, the non-ablative CO laser.

Aim: This study aimed to assess the efficacy and safety of the non-ablative CO laser in menopausal women with VVA as a monotherapy or in association with vaginal estriol or moisturizer.

Methods: Seventy-five women with VVA received laser treatment (Laser group), laser plus estriol gel (Laser+E) or laser plus moisturizers (Laser+M). Read More

J Low Genit Tract Dis 2022 Jul 11;26(3):245-249. Epub 2022 Mar 11.

Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Objectives: Although carbon dioxide laser vaporization is frequently used for treating vaginal intraepithelial neoplasia (VaIN), the optimal depth of epithelial destruction with laser vaporization requires elucidation. We aimed to evaluate VaIN depth and better illustrate epithelial destruction during laser vaporization.

Materials And Methods: We included 246 women diagnosed with VaIN (low-grade VaIN [VaIN 1], 123 women; high-grade VaIN [VaIN 2/3], 123 women) using colposcopy-directed biopsy at our hospital from January 1, 2019, to April 30, 2020. Read More

Lasers Med Sci 2022 Jul 9;37(5):2413-2420. Epub 2022 Mar 9.

Department of Dermatology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College(PUMC), Beijing, China.

The fractional CO laser is a type of ablative laser. In this study, a novel fractional CO laser therapeutic apparatus was developed for cervical diseases. To compare the depth and diameter of penetration as well as the stability of a novel laser against a control laser emitting at the same wavelength, we tested this using a rhesus monkey model. Read More

J Sex Med 2022 03 29;19(3):452-470. Epub 2022 Jan 29.

Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy.

Background: Genitourinary syndrome of menopause (GSM) is a widespread condition with a great impact on quality of life and self-image.

Aim: We aimed to systematically review the current literature on CO2-Laser therapy efficacy for the treatment of GSM.

Methods: MEDLINE and Embase databases were systematically queried in December 2020 Studies included women with a diagnosis of Vulvo-Vaginal Atrophy (VVA) or GSM without an history of gynaecological and/or breast cancer, pelvic organ prolapse staged higher than 2, pelvic radiotherapy or Sjogren's Syndrome. Read More

JAMA Oncol 2022 04;8(4):618-628

Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.

Importance: Extramammary Paget disease (EMPD) is a frequently recurring malignant neoplasm with metastatic potential that presents in older adults on the genital, perianal, and axillary skin. Extramammary Paget disease can precede or occur along with internal malignant neoplasms.

Objective: To develop recommendations for the care of adults with EMPD. Read More

JAMA 2022 01;327(3):283

Department of Plastic Surgery, Xinhua Hospital, Shanghai, China.

Lasers Med Sci 2022 Jun 6;37(4):2203-2208. Epub 2022 Jan 6.

Department of Obstetrics and Gynecology, Kaohsiung Medical Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

The purpose of our study was to investigate the effects of vulvovaginal erbium laser on the genitourinary syndrome of menopause (GSM) and sexual function of postmenopausal women. We conducted a retrospective study of sixty-four postmenopausal women with GSM, and these patients were scheduled for three times of vulvovaginal erbium laser treatment. A baseline and post-treatment vaginal status was assessed by measuring vaginal pH, patients' subjective vulvovaginal atrophy (VVA) symptoms, which included dryness, dyspareunia, itching, and burning. Read More

Photobiomodul Photomed Laser Surg 2021 Dec;39(12):782-788

Laser Cutaneous Cosmetic and Plastic Surgery Unit, Villa Donatello Clinic, Florence, Italy.

Fractional carbon dioxide (CO) lasers are today considered the most effective and efficient treatment for many vulvovaginal disorders, providing mini-invasive procedures without side effects. Previous studies demonstrated the efficacy of fractional CO lasers in vulvar lichen sclerosus (VLS), a chronic skin disorder characterized by itching and painful lesions. Complications include pain, sexual and/or urinary dysfunction, with a negative quality of life, and an increased risk of squamous cell carcinoma. Read More

Photobiomodul Photomed Laser Surg 2021 Nov 27;39(11):716-724. Epub 2021 Oct 27.

Rüti Medical Center, Rüti, Switzerland.

We aimed to evaluate real-world data for the use of fractional CO laser therapy for treating symptoms of vulvovaginal atrophy (VVA). VVA is widespread and can reduce the patients' quality of life. There is a lack of data regarding its therapy with laser, especially for daily practice (i. Read More

Climacteric 2022 Jun 25;25(3):228-234. Epub 2021 Oct 25.

Department of Medical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

Genitourinary syndrome of menopause (GSM) may arise from the hypoestrogenism caused by ovarian function destruction following gynecological cancer treatments. GSM may also be present in menopausal women and its symptoms might be exacerbated by cancer treatments. Historically, patients with hormone-dependent gynecological cancer and physicians have been less comfortable using vaginal estrogen due to fear of recurrence. Read More

Int J Gynecol Cancer 2021 11 5;31(11):1410-1415. Epub 2021 Oct 5.

Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

Objective: Plasma energy ablation vaporizes tissues similar to carbon dioxide laser ablation, but is not hindered by the unique hazards and regulation of laser technology. We aimed to evaluate the complication rate and effectiveness of plasma versus laser ablation in the treatment of vulvovaginal high-grade squamous intra-epithelial lesions (HSIL).

Methods: We performed a retrospective cohort study of women treated with plasma or carbon dioxide laser ablation for histologically proven HSIL of the vulva or vagina from January 2014 to October 2019 at a single institution. Read More

Lasers Med Sci 2022 Apr 28;37(3):1635-1641. Epub 2021 Sep 28.

Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynecology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.

The purpose of this study is to evaluate the efficiency of CO2 laser colposcopic guided surgery performed in an outpatient see and treat setting in the management of VHSIL. Women with a suspected diagnosis of VHSIL and no vulvoscopic suspicion of vSCC were enrolled. An electronic register of CO2 laser treatment was created where description of performing parameters (excision or ablation) was specified and personal history was recorded. Read More

Photobiomodul Photomed Laser Surg 2021 Sep;39(9):622-629

Hospital Israelita Albert Einstein, Sao Paulo, Brazil.

Rectovaginal fistulas (RVFs) are abnormal tracts that connect the lower gastrointestinal tract with the vagina. They can result from obstetric trauma, infection, local surgeries, cancer, radiation damage, and Crohn's disease. Despite the advances in surgical and clinical treatment, there is no consensus regarding the best line of treatment. Read More

Eur J Obstet Gynecol Reprod Biol 2021 Oct 29;265:220-221. Epub 2021 Jul 29.

Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA.

Lasers Med Sci 2022 Mar 12;37(2):1061-1067. Epub 2021 Aug 12.

Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska Street, 00-575, Warsaw, Poland.

The aim of this study was to assess the safety and efficacy of a minimally invasive pixel-CO laser procedure for the treatment of stress urinary incontinence (SUI). This was a prospective, open-label study with a cohort of 59 women. Patients were treated intravaginally with a fractional/pixel CO laser every 4-6 weeks for a total of three treatments and assessed at 3, 6, and 12 months. Read More

Menopause 2021 08 9;28(11):1316-1322. Epub 2021 Aug 9.

Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

Importance: The research of new therapeutic modalities, especially with energy-based devices, has been increasing nowadays for genitourinary syndrome of menopause (GSM) management. Microablative fractional CO2 laser has been used for pelvic floor dysfunction management.

Objective: To conduct a systematic review and meta-analysis of randomized controlled trials to compare fractional CO2 laser therapy versus sham therapy for GSM management. Read More

Climacteric 2022 Apr 22;25(2):186-194. Epub 2021 Jul 22.

Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain.

Objective: The aim of the study was to evaluate the clinical response and collagen remodeling in the vaginal wall after three sessions of carbon dioxide (CO) laser application.

Methods: Fourteen postmenopausal women with vulvovaginal atrophy, aged 45-65 years and sexually active, were evaluated with clinical questionnaires, gynecological examinations and histological techniques before and after 20 weeks of treatment (ClinicalTrials.gov NCT03939078). Read More

Maturitas 2022 Feb 20;156:37-59. Epub 2021 Jun 20.

Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine-University of Barcelona, Hospital Clinic-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Electronic address:

Background: Genitourinary syndrome of menopause (GSM) can have a great impact on the quality of life (QOL), and affects between 53.8% and 90% of postmenopausal women. The literature suggests that vaginal laser therapy could be an effective treatment for GSM symptoms, but its efficacy and safety have not been established and international societies do not endorse its use. Read More

BMC Womens Health 2021 06 6;21(1):235. Epub 2021 Jun 6.

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, 98. Nagyerdei krt., Debrecen, 4032, Hungary.

Background: The 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 CO laser treatment on cervicovaginal lavage (CVL) zinc and copper levels. Read More

Obstet Gynecol 2021 06;137(6):965-967

Dr. Mauskar is from the Departments of Dermatology and Obstetrics and Gynecology at the University of Texas Southwestern Medical Center, Dallas Texas; email:

Obstet Gynecol 2021 06;137(6):979-987

Mercer University Physician Assistant Program, Atlanta, Georgia; the Centers for Vulvovaginal Disorders the Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC; the Department of Pathology and Laboratory Medicine and the Department Obstetrics, Gynecology, and Women's Health, Rutgers New Jersey Medical School, Newark, and Women's Healthcare of Princeton, Princeton, New Jersey; and Strategic Research, Laerdal Medical, Stavanger, Norway.

Objective: To estimate the efficacy of fractionated carbon dioxide (CO2) laser therapy for vulvar lichen sclerosus.

Methods: We conducted a prospective, double-blind, randomized, sham-controlled, trial conducted in a clinic specializing in vulvar disorders. The study participants were 40 women with active vulvar lichen sclerosus confirmed with biopsy who were abstaining from topical and systemic treatments for at least 4 weeks before enrollment. Read More

Obstet Gynecol 2021 06;137(6):968-978

Department of Obstetrics and Gynecology, Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center and Georgetown University School of Medicine, Washington, DC; the Department of Biostatistics, Medstar Health Research Institute, Hyattsville, Maryland; the Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Health System, Pittsburgh, Pennsylvania; the Department of Urogynecology, Brown Women & Infants Hospital of Rhode Island, Providence, Rhode Island; and the Department of Subspecialty Care for Women's Health, Cleveland Clinic, Cleveland, Ohio.

Objective: To compare 6-month safety and efficacy outcomes of fractionated CO2 laser (laser) with topical clobetasol propionate (steroid) for treatment of symptomatic vulvar lichen sclerosus.

Methods: We conducted a single-center randomized controlled trial that compared fractionated CO2 laser with steroid treatment for patients with biopsy-proven lichen sclerosus. Randomization was stratified by prior clobetasol propionate use. Read More

Breast Cancer Res Treat 2021 Jul 23;188(2):501-509. Epub 2021 Apr 23.

Department of Cancer Medicine/Gynecology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France.

Purpose: Women with breast cancer (BC) often suffer from severe vulvovaginal atrophy (VVA) which ultimately leads to poor sexual and urinary quality of life. We conducted a prospective study among women with BC and VVA, in order to evaluate the long-term effect of laser therapy on VVA.

Methods: Women with BC and VVA were proposed to have fractional microablative CO laser therapy (MonaLisaTouch®, DEKA) once per month for 3 months. Read More

Lasers Surg Med 2021 11 9;53(9):1146-1151. Epub 2021 Apr 9.

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, 3525408, Israel.

Background And Objectives: Vaginal fractional carbon dioxide (CO ) laser treatment has emerged in the past two decades as a non-surgical option for vaginal tightening. Mounting evidence supports the effectiveness and safety of this treatment for female sexual dysfunction. A newly developed vaginal tactile imaging (VTI) technique accurately evaluates the biomechanical parameters of the female pelvic floor and vagina, including tissue elasticity, pelvic support, and pelvic muscle function in high definition. Read More

J Sex Med 2021 04 20;18(4):761-769. Epub 2021 Mar 20.

Advanced Urogynecology of Michigan, P.C., Dearborn, MI, USA; Department of Female Pelvic Medicine & Reconstructive Surgery, Beaumont Health, Wayne, MI, USA.

Background: Despite some prospective case series showing effectiveness of vaginal laser to treat genitourinary syndrome of menopause (GSM), there is a paucity of placebo-controlled level one evidence.

Aim: To assess the effect of fractional carbon dioxide (CO) laser therapy to treat GSM against a sham comparator.

Methods: We conducted a parallel, randomized, double-blind, sham-controlled trial to compare menopausal women treated with fractional CO laser against sham treatment for improvement in GSM-related dyspareunia. Read More

Clin Breast Cancer 2021 10 23;21(5):e539-e546. Epub 2021 Feb 23.

School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Gynecology and Obstetrics, Urogynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Background: Breast cancer (BC) is the most common female cancer worldwide. Menopausal symptoms are a well-known side effect in women with BC and have a significant negative impact on quality of life (QoL) and sexuality. Nowadays, hormonal replacement therapy and local estrogens are the most common prescriptions to treat vulvovaginal (VVA) symptoms. Read More

Breast J 2021 05 16;27(5):448-455. Epub 2021 Mar 16.

Division of Gynecology and Obstetrics, Umberto I Hospital, University of Turin, Turin, Italy.

Adjuvant chemotherapy and endocrine therapy can induce early iatrogenic menopause or worsen pre-existing menopausal symptoms in breast cancer survivors (BCS). The second most frequent menopausal symptom after hot flushes is the genitourinary syndrome (GSM). Since hormone replacement therapy is contraindicated in BCS, vaginal laser might represent a new nonhormonal option for GSM. Read More

Lasers Med Sci 2022 Feb 15;37(1):359-367. Epub 2021 Mar 15.

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China.

The purpose of this study is to evaluate the efficacy and safety of vaginal fractional CO laser therapy for female sexual dysfunction (FSD). A total of 84 women at high risk of sexual dysfunction were randomly divided into two groups. Women in the laser group received vaginal fractional CO laser therapy. Read More