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The effectiveness of pixel co2 laser in the treatment of sexual complaints of patients with vulvovaginal atrophy

Pereyra, EAG1; Fonteles, LP1; Lerner, T1; Soares-Jr, JM1; Baracat, EC1

1: Divisão da Clínica Ginecológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil

Introduction: menopause is associated with anatomical and physiological changes of the vagina, wich can lead to sexual and urinary symptoms. CO2 laser is a promising method for the treatment of vulvovaginal symptoms associated.

Objective: to assess the effects of pixel co2 laser in the treatment on sexual complaints in patients with vulvovaginal atrophy

Patients and Method: 33 subjects with vulvovaginal atrophy were submitted to 1 to 3 treatment sessions of vaginal pixelated CO2 laser (Alma Laser FemiliftTM), consisting in 3 sets of 12 circunferencial pulses at 1cm increments from de vaginal apex until the introitus at 100mj/pixel, ablation matrix 9x9 dots, pulse mode 1Hz. Each patient answered a questionnaire where they described sexual and urinary symptoms in a scale and were evaluated about physical changes in vaginal anatomy before and after every procedure.

Endpoints: Sexual intercourse frequence, anatomical changes (vaginal wrinkles, paleness of the mucosa, vaginal wall fragility, haemorragic suffusion, endocervical mucus) ; subjective response of patients about: pain at intercourse (penetration and in depth), urinary incontinence, desire, orgasm, dryness.

Result: The number of sexual intercourse per month improved after the laser during the follow up: 1,85 ± 2.17 (baseline), 3.71 ± 3.74 (1st month of treatment), 5.78 ± 6.40 (2nd month of treatment), 7.6,40 ± 6,17 (3rd month of treatment, p<0.01 compared the baseline with 2nd and 3rd month of treatment). The time of menopause negatively influenced on the results (p<0.05). The superficial and deep pain in the sexual intercourse complains of patients significantly decreased after the treatment as well as the vaginal dryness. The stress urinary incontinence ameliorated after treatment in 80% of patients. The number of fecal incontinence was low in our sample.

Conclusion: Vaginal CO2 laser improved the frequency of sexual intercourse and ameliorated sexual complaints and stress urinary incontinence in patients with vulvovaginal atrophy.


Work supported by industry: yes, by Alma Lasers, Israel (industry funding only - investigator initiated and executed study).

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