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Obstet Gynecol 2021 May 6. Epub 2021 May 6.

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

J Sex Med 2021 Apr 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

Khirurgiia (Mosk) 2021 (1):55-61

Sechenov First Moscow State Medical University, Moscow, Russia.

Objective: To develop the optimized complex programs, including general magnetotherapy, fractional microablative therapy with a CO2 laser, electromyostimulation with biofeedback of the pelvic floor muscles, and a special exercise therapy complex in late rehabilitation programs for women of different age after reconstructive plastic surgery for rectocele.

Material And Methods: There were 200 women of childbearing, peri- and menopausal age with rectocele grade II-III and 20 healthy women of comparable age. All patients were divided into 4 groups by 50 womes: main group, two comparison groups and control group. Read More

Int J Clin Oncol 2021 Apr 4;26(4):770-776. Epub 2021 Jan 4.

Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: Cervical intraepithelial neoplasia (CIN) is a precancerous lesion that may progress to invasive cervical cancer without intervention. We aim to examine the prognostic outcomes and risk factors for recurrence after laser vaporization for CIN 3, CIN 2 with high-risk human papillomavirus (HPV) infection, and CIN 1 persisting for more than 2 years.

Methods: Between 2008 and 2016, a total of 1070 patients underwent cervical laser vaporization using a carbon dioxide laser. Read More

Khirurgiia (Mosk) 2020 (11):79-85

Federal State Autonomous Educational Institution of Higher Education named after I.M. Sechenov of the Ministry of Health of Russia (Sechenov University), Moscow, Russia.

The article presents data on the treatment of 200 women of childbearing, peri - and menopausal age with rectocele of II-III degree, which were divided into 4 groups comparable in clinical and functional characteristics: 1-50 patients who, after surgical treatment of rectocele, underwent a complex consisting of a course of General magnetic therapy, 2 intra-vascular procedures of fractional microablative CO laser therapy, electromyostimulation with the pelvic floor muscles and a special complex of therapeutic physical education; comparison 1, which included 50 patients who underwent the above-mentioned complex of rehabilitation measures without General magnetotherapy; comparison of 2-50 patients after surgical treatment of rectocele, who in the late postoperative period (one month after the operation) underwent a set of rehabilitation measures, including a course of electromyostimulation with the biological connection of the pelvic floor muscles, consisting of 10 daily procedures and a special complex of physical therapy and a control group - 50 patients after surgical treatment of rectocele, who in the late postoperative period were treated with symptomatic therapy, including painkillers and antispasmodics, which served as a background for all other groups. As a result of the research, it was found that the developed rehabilitation complexes have a pronounced myostimulating effect, and can be recommended for wide use in rehabilitation programs for postoperative management of patients with rectocele. Read More

Lasers Med Sci 2020 Oct 16. Epub 2020 Oct 16.

Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.

Deep dyspareunia affects almost half of the women with endometriosis and is associated with vaginal endometriotic lesions. Our pilot study's objective is to assess the feasibility and effectiveness of CO-laser ablation under colposcopic guidance for the treatment of symptomatic vaginal endometriosis. A non-comparative pilot study has been performed. Read More

Dermatol Surg 2020 11;46(11):1397-1402

Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon.

Background: Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease. Topical treatments often yield ineffective and temporary results. Read More

Am J Obstet Gynecol 2020 12 17;223(6):890.e1-890.e12. Epub 2020 Jun 17.

Division of Urogynecology, Department of Obstetrics and Gynecology, Stanford University Hospital, Palo Alto, CA.

Background: Topical vaginal estrogen therapy is considered the gold standard treatment for genitourinary syndrome of menopause-associated dyspareunia, but early investigations of energy-based devices show promise for patients with contraindications or those who are refractory to vaginal estrogen cream therapy. Although evaluating safety, efficacy, and long-term outcomes for novel technologies is critically important when new technologies become available to treat unmet healthcare needs, evaluation of the costs of these new technologies compared with existing therapies is also critically important but often understudied.

Objective: We sought to perform a cost-effectiveness analysis of 3 therapies for genitourinary syndrome of menopause, including vaginal estrogen therapy, oral ospemifene therapy, and vaginal CO laser therapy and determine if vaginal laser therapy is a cost-effective treatment strategy for dyspareunia associated with genitourinary syndrome of menopause. Read More

Fertil Steril 2020 06;113(6):1319-1327.e3

Department of Obstetrics and Gynecology, Leuven University Fertility Center, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium.

Objective: To evaluate the rate of postoperative complications between conservative surgery and segmental resection in patients with rectal endometriosis.

Design: Single-center retrospective study.

Setting: University hospital. Read More

Menopause 2020 08;27(8):858-863

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Objective: The aim of this study was to evaluate the efficacy of vaginal CO2 laser for the treatment of vaginal atrophy compared to the sham procedure.

Methods: Between June 2016 and May 2017, postmenopausal women with moderate to severe intensity of any vaginal atrophy symptoms (VAS) were invited to participate in the study. A total of 88 women were randomized to receive treatment with either vaginal CO2 laser or sham procedures every 4 weeks for three sessions. Read More

BJOG 2020 10 17;127(11):1338-1346. Epub 2020 May 17.

Cluster Urogenital and Abdominal Surgery, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.

Background: Laser therapy is now being proposed for the treatment of pelvic organ prolapse (POP) and urinary incontinence (UI).

Objectives: To systematically review the available literature on laser therapy for POP and UI.

Search Strategy: PubMed, Web Of Science and Embase were searched for relevant articles, using a three-concept (POP, UI, laser therapy) search engine composed as (concept 1 OR concept 2) AND concept 3. Read More

Int J Gynecol Cancer 2020 05 27;30(5):590-595. Epub 2020 Mar 27.

Department of Gynecology, University Campus Biomedico, Rome, Italy

Background: Many women diagnosed with gynecological cancers undergo adjuvant therapy, which may lead to transient or permanent menopause that ultimately leads to urogenital syndrome and vulvovaginal atrophy. Studies advise against the use of estrogen in women with a history of hormone-dependent cancer. One alternative is vaginal microablative fractional CO laser, which promotes tissue regeneration through the production of collagen and elastic fibers. Read More

J Low Genit Tract Dis 2020 Apr;24(2):225-228

Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA.

Objectives: The aim of this study was to evaluate the efficacy of the fractionated CO2 laser in treating recalcitrant lichen sclerosus (LS).

Materials And Methods: The study population was 40 women diagnosed with LS who were symptomatic despite medical treatment. Patients had at least 2 or more laser sessions with a 2-month follow-up visit at the Drexel Vaginitis Center. Read More

Eur J Obstet Gynecol Reprod Biol X 2020 Jan 22;5:100099. Epub 2019 Oct 22.

Centre for Advanced Reproductive Endosurgery, Sydney, Australia.

Objectives: To evaluate the safety, feasibility and efficacy of trans-vaginal fractional micro-ablative CO laser therapy in combination with platelet rich plasma (PRP) for the treatment of stress urinary incontinence (SUI) in women.

Study Design: Participants with SUI underwent three sessions of transvaginal CO laser and PRP treatment, administered at 4-6-week intervals. Outcomes were assessed using the bladder function section of the Australian Pelvic Floor Questionnaire (APFQ). Read More

Female Pelvic Med Reconstr Surg 2020 02;26(2):155-158

From the Department of Obstetrics & Gynecology, University of California Irvine Medical Center, Orange.

Objective: Optical coherence tomography is a noninvasive technology that visualizes tissue microstructure with high spatial resolution. We designed a novel vaginal system that demonstrates a clear distinction between vaginal tissues planes. In this study, we sought to compare vaginal tomographic images of premenopausal, perimenopausal, and postmenopausal women, demonstrate feasibility of tracking vaginal tissue changes after treatment with fractional-pixel CO2 laser therapy, and obtain a histologic correlation of these findings. Read More

Menopause 2020 01;27(1):43-49

Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy.

Objective: Genitourinary syndrome of menopause (GSM), especially vulvovaginal atrophy (VVA), is one of the most common conditions among women in either natural (4%-47%) or medically induced (23.4%-61.5%) menopause. Read More

Biochem Pharmacol 2020 01 14;171:113713. Epub 2019 Nov 14.

Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address:

Oral cancer is a prevalent cancer in male worldwide. Oral potentially malignant disorders (OMPDs) are the oral mucosa lesions that have high malignant transformation rate to oral cancer. The mainstay for OMPDs treatment includes carbon dioxide (CO) laser and surgery, which may lead to the side effects of scarring and impaired function of oral cavity in the patients and reduced their willingness to receive curative therapy. Read More

Orv Hetil 2019 Oct;160(41):1617-1622

Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Eastern Virginia Medical School Norfolk, VA, USA.

Genitourinary syndrome of menopause (GSM) affects up to 40-57% of postmenopausal women. Intravaginal microablative fractional CO laser is a new proposal for the management of GSM, although the evidence of safety and efficacy of the procedure appears to be insufficient. The aim of the study was to assess the efficacy of fractional CO laser for the treatment of GSM at the Department of Obstetrics and Gynecology of the University of Debrecen. Read More

Pol Merkur Lekarski 2019 Aug;47(278):60-64

Medicover Hospital, Department of Obstetric and Gynecology, Warsaw, Poland.

Endometriosis affects 10-15% of the female population of childbearing potential. Endometrioid lesions of the cervical surface are a rare manifestation of the disease. There are various complaints related to this particular form of endometriosis, making the diagnosis challenging. Read More

Ultrasound Obstet Gynecol 2020 Jan;55(1):134-135

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

J Gynecol Obstet Hum Reprod 2020 Mar 6;49(3):101614. Epub 2019 Jul 6.

GH Nord Essonne, Longjumeau, France; Plastic surgery service, France.

Objectives: The aim of this research was to assess the efficacy of the new generation micro-fractional CO2 laser low dose energy (Aphrodite, BH LASER, France) in the treatment of genitourinary syndrome.

Materials And Methods: This prospective interventional clinical study, included a total of 25 menopausal symptomatic patients and 25 non-menopausal symptomatic patients having symptoms of vulvovaginal atrophy. There were only two laser sessions spaced at 6 weeks. Read More

Arch Gynecol Obstet 2019 09 8;300(3):661-668. Epub 2019 Jul 8.

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Purpose: Human papillomavirus (HPV) can cause condylomata acuminata, also known as genital warts. Our aim was to evaluate the long-term recurrence of genital warts after primary carbon dioxide laser treatment before the introduction of the vaccination against HPV.

Methods: Recurrence rate and localization of genital warts were analysed in a retrospective study in 1798 women presenting with a new diagnosis of genital warts from 1992 to 2009 at a University hospital and had received laser treatment. Read More

Lasers Surg Med 2019 12 25;51(10):882-886. Epub 2019 Jun 25.

Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 526, Norfolk, Virginia, 23507-2007.

Background And Objectives: To assess the improvement on pelvic floor distress (PFD)-related urogenital symptoms using validated questionnaires after intravaginal CO laser treatment.

Study Design/materials And Methods: Forty postmenopausal women with genitourinary symptoms of menopause (GSM) were enrolled into this prospective cohort study and underwent vaginal laser treatment using MonaLisa Touch® fractional CO laser system. Patients received three vaginal laser treatments with 360° probe 4 weeks apart. Read More

Photobiomodul Photomed Laser Surg 2019 Jul 17;37(7):451-454. Epub 2019 Jun 17.

7 Ultraimagem, Juiz de Fora, Minas Gerais, Brazil.

Rectovaginal fistulas (RVFs) are defined as any connection between the anorectum and the vagina. They can have several causes, being Crohn's disease, the second leading cause of RVFs, responsible for ∼10% of the RVFs. Despite the advances in surgical and clinical treatment, there is no consensus regarding the best line of treatment. Read More

J Gynecol Obstet Hum Reprod 2019 10 30;48(8):685-688. Epub 2019 Apr 30.

Federative pelvi-perineology centre, University Hospital of Nantes, 44093, Nantes, France.

Surg Technol Int 2019 May;34:35-39

Las Vegas Minimally Invasive Surgery and Women's Pelvic Health Center, WellHealth Quality Care, a DaVita Medical Group, Obstetrics and Gynecology, University of Nevada, Las Vegas, School of Medicine, Las Vegas, Nevada.

Introduction: The objective of this study was to understand how J-Plasma® (Bovie Medical Corporation, Clearwater, Florida) surgical energy compares to monopolar, argon beam, and CO2 laser devices in terms of depth of penetration and lateral thermal spread in a porcine tissue model.

Materials And Methods: Using a porcine animal model, we applied the thermal energy of the J-Plasma® laser, Bovie Monopolar Pencil™ (Bovie Medical Corporation, Clearwater, Florida), argon beam coagulator, and CO2 laser to porcine small bowel, bladder, and peritoneal tissues at equivalent settings. Tissue was excised and sent to pathology for histologic evaluation. Read More

Arch Pathol Lab Med 2019 08 19;143(8):1006-1011. Epub 2019 Feb 19.

From the Gynecological Oncology Unit (Drs Sopracordevole and del Fabro and Ms Buttignol) and the Pathology Unit (Drs Canzonieri and Alessandrini), Centro di Riferimento Oncologico-National Cancer Institute, Aviano, Italy; the Woman's Health Sciences Department, Gynecologic Section, Università Politecnica delle Marche, Ancona, Italy (Drs Carpini, Serri, and Ciavattini); and the Department of Obstetrics, Gynecology, and Pediatrics, Azienda Sanitaria Universitaria Integrata Udine, Udine, Italy (Dr Cagnacci). Dr Alessandrini is now with the General Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.

Context.—: A significant negative trend in length of cone excision has been observed in recent years, leading to a higher percentage of positive endocervical excision margin and close (<1 mm) negative endocervical margin cases.

Objective. Read More