ObjectivesGenitourinary syndrome of menopause (GSM) combines the conditions of vulvovaginal atrophy (VVA) and urinary tract dysfunction, which is a result of urethral atrophy. There are several treatment methods available for the management of vulvovaginal symptoms of GSM, whereas urinary tract dysfunction often remains overlooked and undertreated. The objective of this pilot study was to assess the safety and efficacy of intraurethral Er:YAG laser treatment of urinary symptoms of GSM.Patients and MethodsPatients with diagnosed GSM, having less than 5% of vaginal superficial cells in the cytology, vaginal pH higher than 5, with urinary symptoms of GSM (dysuria, frequency, urgency) and impaired continence due to urethral atrophy, received two sessions of intraurethral Er:YAG laser with a 3‐week interval in‐between the sessions. Laser energy was delivered in non‐ablative way using Erbium SMOOTH™ mode technology and a 4‐mm thick cannula. Therapeutic efficacy was determined using ICIQ‐SF, the 1‐hour pad test and VAS scores. Occurrence of adverse effects was followed at every visit. Follow ups (FU) were at 3 and 6 months.Results29 female patients fulfilling the inclusion criteria were included in this pilot study and received two sessions of the intraurethral non‐ablative Erbium SMOOTH™ laser therapy. Significant improvement was observed in all measured parameters at both FU. ICIQ‐SF improved by an average of 64% at 3 months FU and by 40% at 6 months. The 1‐hour pad test showed a reduction of the quantity of leaked urine by 59% at 3 months FU and by 42% at 6 months FU. All urinary symptoms of GSM improved. Dysuria dropped to 13% and 31% of baseline values at three and 6 months respectively, urinary urgency dropped to 23% and 47% and frequency dropped to 22% and 43% after 3 and 6 months, respectively. Adverse effects were mild and transient.ConclusionsOur findings suggest that intraurethral Er:YAG laser is an efficacious and safe modality for treatment of urinary symptoms of GSM, however, prospective, randomized, and controlled trials with larger number of patients are needed to better assess the long‐term effect of this novel procedure. Lasers Surg. Med. 50:802–807, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

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Background Warts are benign epithelial proliferations that result from human papillomavirus (HPV) infection occurring on the skin and mucosa. Patients express a significant reduction in quality of life due to this cosmetic nuisance, as well as functional problems and physical discomfort. Newer methods of wart removal include different energy‐based devices, mostly lasers. Nonablative lasers such as Nd:YAG have a higher success rate and are usually used with topical or infiltrative anesthesia. The procedure may be safer without anesthesia but still tolerable with an appropriate cooling and technique. Aims The purpose of this study is to report on our experience over 3 years since the approach without anesthesia has been utilized. Patients/Methods A retrospective chart review analysis of all 85 patients who underwent 1064 nm Nd:YAG wart removal without anesthesia between November 2016 and August 2019 was conducted. One of the main outcome measures was determining the number of sessions required in order to get full clearance. Results The mean number of sessions was 2.2 (range 1‐7). The mean VAS pain score during the procedure was 6 (range: 2‐10), and side effects were negligible. Conclusion Long‐pulse 1064‐nm Nd:YAG laser without any chemical anesthesia is safe and effective for the treatment of warts.

BACKGROUND Successful treatment of acne scars in ethnic skin requires procedures that are safe and effective with a low incidence of hyper or hypopigmentation postoperatively. OBJECTIVE In this study, the safety and efficacy of a combined treatment protocol including tumescent anesthesia, subcision, trichloracetic acid peel, and fractional erbium laser resurfacing was evaluated. METHODS This is a retrospective study of 56 patients (22 women and 34 men) with predominantly rolling acne scars and Fitzpatrick skin Types IV–VI who were treated using a combination of tumescent anesthesia, extensive subcision, fractional ablative erbium laser, and a blending 20% trichloracetic acid (TCA) peel. RESULTS The mean improvement after a single treatment, assessed by 3 independent evaluators (2 dermatologist and 1 dermatology physician assistant), was 2.52 (SD = 1.04) on a scale of 1 to 4. CONCLUSION The combination of tumescent anesthesia, extensive subcision, fractional ablative erbium laser resurfacing, and a blending 20% TCA peel (combined procedure) is both safe and effective in the treatment of rolling acne scars in ethnic skin types with acceptable temporary adverse effects.

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