PDF(Pubmed)
Abstract：
Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder-urethral regions related to menopause changes, negatively influencing woman\'s quality of life and sexual activity. Fractional micro-ablative CO2 laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO2 laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO2 laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women.
摘要：
更年期泌尿生殖系统综合征（GSM）包括与更年期变化相关的外阴阴道和/或膀胱尿道区域的一系列令人痛苦的症状，负面影响女性的生活质量和性活动。分数微消融CO2激光治疗已显示出将阴道上皮恢复到类似于绝经前状态的潜力，从而改善与GSM相关的主观症状。我们进行了一个前瞻性的，对73名性活跃的绝经后妇女进行了初步研究，接受CO2激光治疗，以治疗其GSM症状，同时通过女性性功能指数（FSFI）问卷评估阴道健康指数评分（VHIS）和性功能。激光治疗导致VHIS和患者报告的外阴阴道萎缩（VVA）症状减少，阴道瘙痒的患病率明显降低，干燥度,和燃烧(p<0.001)，以及性交困难（p=0.002）。尿失禁的发生，紧迫性,阴道的沉重程度显著降低，随着膀胱膨出分期的改善，达到阶段1或完全分辨率（p<0.001）。治疗后FSFI总分和领域评分均明显增高，表明更好的性功能，治疗后评分中位数为25分（p<0.001）。因此,在绝经后女性中,使用三周期分数阶CO2激光是减少与GSM相关的泌尿生殖器不适的有效选择.
