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Abstract：
Background and Objectives: Postmenopausal vaginal discomfort is often attributed to vulvovaginal atrophy (VVA). Women with VVA experience symptoms such as vaginal dryness, itching, burning, irritation, and dyspareunia. Materials and Methods: This pilot study was conducted to assess the effects of a micro-ablative fractional CO2 laser on the clinical symptoms of VVA, as well as concordant sexual function. The severity of VVA symptoms was evaluated by a visual analogue scale (VAS), while the condition of the vaginal mucosa was evaluated using the Vaginal Health Index Score (VHSI). Sexual function was evaluated using the Female Sexual Function Index (FSFI) Questionnaire. Results: Our cohort included 84 sexually active postmenopausal women with bothersome VVA, leading to sexual health complaints. The mean age of the participants in our study was 55.2 ± 5.4 years, with an average postmenopausal period of 6 ± 4.8 years. The age of our patients and the length of their postmenopausal period exhibited a significant negative correlation with VHSI scores, while a longer postmenopausal period was associated with increased severity of vaginal dryness and dyspareunia. Baseline VHSI values showed that 65% of patients had atrophic vaginitis with pronounced VVA symptoms (70.2% experienced vaginal itching, 73.8% reported vaginal burning, 95.3% had vaginal dryness, and 86.1% suffered from dyspareunia). Lower VHSI values significantly correlated with lower FSFI scores, while more severe VVA symptoms scores correlated with lower FSFI scores. VVA symptoms were significantly less severe after treatment. VHIS regained high non-atrophic values in 98.8% of patients post-treatment (p < 0.001). FSFI total and domain scores were significantly higher after treatment (p < 0.001). Conclusions: Our study revealed that fractional CO2 laser is a useful treatment option to alleviate VVA symptoms and improve vaginal health and sexual functioning in postmenopausal women.
摘要：
背景和目的：绝经后阴道不适通常归因于外阴阴道萎缩（VVA）。患有VVA的女性会出现阴道干燥等症状，瘙痒,燃烧,刺激,和性交困难.材料和方法：这项初步研究是为了评估微烧蚀分数CO2激光对VVA临床症状的影响，以及协调的性功能。通过视觉模拟评分(VAS)评估VVA症状的严重程度,同时使用阴道健康指数评分（VHSI）评估阴道粘膜的状况。使用女性性功能指数（FSFI）问卷评估性功能。结果：我们的队列包括84名性活跃的绝经后女性，患有烦人的VVA，导致性健康投诉。研究参与者的平均年龄为55.2±5.4岁，平均绝经后6±4.8年。我们患者的年龄和绝经后的时间与VHSI评分呈显著负相关，而绝经后时间延长与阴道干燥和性交困难的严重程度增加相关。基线VHSI值显示，65％的患者患有萎缩性阴道炎，VVA症状明显（70.2％经历阴道瘙痒，73.8%报告阴道灼烧，95.3%有阴道干燥,86.1％患有性交困难）。较低的VHSI值与较低的FSFI评分显着相关，而更严重的VVA症状评分与更低的FSFI评分相关。治疗后VVA症状明显减轻。98.8%的患者在治疗后VHIS恢复了较高的非萎缩性值(p<0.001)。FSFI总分和领域评分在治疗后显著升高(p<0.001)。结论：我们的研究表明，分数CO2激光是缓解VVA症状并改善绝经后妇女阴道健康和性功能的有用治疗选择。
