Carbon dioxide laser treatment for vulvovaginal atrophy in women treated for breast cancer: Preliminary results of the feasibility EPIONE trial

Hersant, Barbara; Werkoff, G.; Sawan, Dana; SidAhmed-Mezi, Mounia; Bosc, Romain; Padula, Simone La; Kalsoum, Sarah; Ouidir, Nabila; Meningaud, Jean Paul; Belkacémi, Yazid

doi:10.1016/j.anplas.2020.05.002

Cited by 60 publications

(44 citation statements)

References 28 publications

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“…A total of 114 papers were included according to the eligibility criteria listed above. Of these, 111 studies investigated GSM, VVA, UI, and LS symptoms as primary indication (Tables 3–6); 15 RCT, 23–37 87 cohort studies, 38–124 eight case reports, 125–132 one case‐control study, 133 including a total of 9000 women, not accounting for overlap between the studies. Additionally, three cross‐sectional studies focused solely on the characteristics of AEs 134–136 .…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, 81 studies investigated CO 2 ‐LASER from different manufacturers 23–31,33,35,36,38–58,66–93,95–104,122–125,128–131,133,136 . Twenty‐eight studies investigated Er:YAG LASER from different manufacturers 32,34,59–65,94,107–121,127,132,135 .…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐four studies examining the effect of vaginal LASER on VVA were identified through this review (Table 4). 29–32,66–94,126 The studies include 2464 women with study sizes ranging from 2 to 386 women with a median (IQR) of 46 (28.25–86.5) women. Among these studies, 31 studies investigated the effect of CO 2 LASER 29–31,66–93 and two studies the effect of Er:YAG 32,94 .…”

Section: Resultsmentioning

confidence: 99%

“… 29–32,66–94,126 The studies include 2464 women with study sizes ranging from 2 to 386 women with a median (IQR) of 46 (28.25–86.5) women. Among these studies, 31 studies investigated the effect of CO 2 LASER 29–31,66–93 and two studies the effect of Er:YAG 32,94 . Four RCTs included 188 women 29–32 and 29 cohort studies included 2274 women; 66–94 a case report of two cases included one case treated with CO 2 and one with Er:YAG for VVA 126 …”

Section: Resultsmentioning

confidence: 99%

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The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Mortensen

Christensen

Løkkegaard

2022

Acta Obstet Gynecol Scand

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In recent years, LASER has been introduced as a minimally invasive treatment for a broad range of vaginal and vulvar symptoms and diseases. However, the efficacy and safety of vaginal and vulvar LASER has continuously been questioned. The aim of this study is to create an overview of the current literature and discuss the controversies within the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus. A search string was built in PubMed.The search was commenced on August 25, 2021 and closed on October 27, 2021. Two authors screened the studies in Covidence for inclusion according to the eligibility criteria in the protocol. The data were extracted from the studies and are reported inThe authors set up an internal protocol to use as a guideline for the review, listing the criteria and outcomes for this review. The eligibility criteria for this state-of-the-art review adhered to the principals of PICO-participants, interventions, comparison and outcome. Studies that investigated the effect of any vaginal and vulvar LASER on women with symptoms of GSM, VVA, UI or LS were eligible for inclusion. No outcome restrictions were applied.Only original studies were included; unpublished work, editorials, conference abstracts, reviews and meta-analysis were excluded.Likewise, in vivo studies on animals, histologic cohort studies, and studies of the effect of radiofrequency treatment were excluded.indications as a treatment should be kept on a research level until further high-quality evidence is available.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Mortensen

Christensen

Løkkegaard

2022

Acta Obstet Gynecol Scand

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“…Summary of study characteristics is presented in Tables 1 and 2. Of the 36 studies, 11 described topical interventions; 11 described laser interventions; 8 described psychoeducational interventions; 3 described multimodal approaches; and 3 described pharmacological studies 40-75 . All 22 nonrandomized studies were before-after studies (without a control group), consisting of 17 interventional trials and 5 cohort studies.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

et al. 2022

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Importance: Cancer and its treatment negatively affect female sexual health and function. The prevalence of female sexual dysfunction after cancer is between 33% and 43%. Numerous studies have addressed treatment options for sexual dysfunction in women with cancer, but it still remains a challenge to select the most efficacious option for patients.Objective: To compile and appraise recent evidence of any interventions for managing sexual dysfunction in female cancer survivors.Evidence Review: A literature search of the electronic databases MEDLINE, EMBASE, PsycINFO, and Cochrane Central Register of Controlled Trials (January 2011 to February 2021) was conducted using general search terms of ''women'', ''cancer'', ''intervention'', ''sexual dysfunction''. We included randomized controlled trials (RCTs) and uncontrolled before-after studies that evaluated the efficacy of intervention for female sexual dysfunction in women with history of cancer. Methodological quality of studies was assessed using Risk of Bias (RoB) 2.0 for RCTs and National Institutes of Health (NIH) assessment tools for uncontrolled before-after studies.Findings: Thirty-six studies were included for qualitative synthesis (14 RCTs (n ¼ 1284), 17 uncontrolled trials (n ¼ 589), and 5 cohort studies (n ¼ 497). Only four studies were at low risk of bias. Topical interventions (vaginal gels or creams) were able to alleviate vaginal dryness and dyspareunia, with intravaginal dehydroepiandrosterone (DHEA) (6.5 mg) gel showing evidence of improved sexual function. Evidence for estriol-lactobacilli vaginal tablets was unreliable due to a small-scale study. Psychoeducational therapy (internet-based cognitive behavioral therapy [CBT]) studies typically were at high risk of bias, but all displayed significant improvements of sexual function. Both laser therapy (fractional CO 2 and erbium) and multimodal approach studies were at concerning risk of bias, although suggesting beneficial effects on sexual function.Conclusions and Relevance: The most reliable evidence for improvement was from a study of DHEA vaginal gel, but in general, gels or creams were useful in reducing dyspareunia. Pharmacological, psychoeducational, laser therapy, and multimodal approaches demonstrated potential in managing cancer-related sexual issues, but most were small in size (10-70 participants), with moderate to high risk of bias. Therefore, large-scale, double-blind, RCTs with long-period follow-up, and at low risk of bias are needed to show efficacy for these interventions.

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Nachsorge nach Mammakarzinomerkrankung

Heilmann

Maass

2020

Gynäkologe

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Carbon dioxide laser treatment for vulvovaginal atrophy in women treated for breast cancer: Preliminary results of the feasibility EPIONE trial

Cited by 60 publications

References 28 publications

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

Nachsorge nach Mammakarzinomerkrankung

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