Effects of local laser treatment on vulvovaginal atrophy among women with breast cancer: a prospective study with long-term follow-up

Veron, Lucie; Wehrer, Delphine; Annerose-Zéphir, Gisèle; Suciu, Voïchita; Delaloge, Suzette; Pistilli, Barbara; Chaltiel, Dan; Pautier, Patricia

doi:10.1007/s10549-021-06226-3

Cited by 24 publications

(65 citation statements)

References 35 publications

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“…The improvement in sexual function persisted at longer-term follow-up of 18 months. There was no patient-reported vaginal dryness or other vaginal symptoms reported [28]. The current study is the first to report follow-up at two years and supports sustained benefit in sexual function but suggests the possibility that the vaginal and urinary symptom benefit may be of shorter duration and may require additional treatments beyond one year.…”

Section: Discussionsupporting

confidence: 54%

“…Fractional CO 2 laser treatment has also been used in women with cancer, most commonly breast cancer. Data based on retrospective [21][22][23] and several small single-arm studies have shown improvement in vaginal symptoms and sexual function [24][25][26][27][28]. A major limitation of these studies has been a lack of long-term follow-up to evaluate persistence of benefit of this intervention.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

Quick

Hundley

Evans

et al. 2022

JCM

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(1) Background: The objective of this study was to determine the long-term efficacy of fractional CO2 laser therapy in breast cancer survivors. (2) Methods: This was a single-arm study of breast cancer survivors. Participants received three treatments of fractional CO2 laser therapy and returned for a 4 week follow-up. Participants were contacted for follow-up at annual intervals. The Vaginal Assessment Scale (VAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scare Revised (FSDS-R), the Urinary Distress Inventory (UDI), and adverse events were collected and reported for the two-year follow-up. The changes in scores were compared between the four-week and two-year and the one-year and two-year follow-ups using paired t-tests. (3) Results: In total, 67 BC survivors were enrolled, 59 completed treatments and the four week follow-up, 39 participated in the one-year follow-up, and 33 participated in the two-year follow-up. After initial improvement in the VAS from baseline to the four week follow-up, there was no statistically significant difference in the VAS score (mean Δ 0.23; 95% CI [−0.05, 0.51], p = 0.150) between the four week follow-up and the two-year follow-up. At the two-year follow-up, the FSFI and FSDS-R scores remained improved from baseline and there was no statistically significant change in the FSFI score (mean Δ −0.83; 95% CI [−3.07, 2.38] p = 0.794) or the FSDS-R score (mean Δ −2.85; 95% CI [−1.88, 7.59] p = 0.227) from the one to two-year follow-up. The UDI scores approached baseline at the two-year follow-up; however, the change between the one- and two-year follow-ups was not statistically significant (mean Δ 4.76; 95% CI [−1.89, 11.41], p = 0.15). (4) Conclusions: Breast cancer survivors treated with fractional CO2 laser therapy have sustained improvement in sexual function two years after treatment completion, suggesting potential long-term benefit.

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

Quick

Hundley

Evans

et al. 2022

JCM

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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‐six studies on the effect of vaginal LASER on GSM were identified through this review (Table 3). 23,24,26–28,38–65,70,125,133 The studies included 4220 women with study sizes ranging from 4 to 1081 women with a median (IQR) of 60.5 (42.25–75.25) women. Among these studies, 29 studies investigated the effect of CO 2 LASER, 23–28,38–58,125,133 counting six RCTs including 336 women 23–28 , and 21 cohort studies including 2251 women 38–58 .…”

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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Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Vaginal Symptom Severity in Postmenopausal Women

Veron

Wehrer

Uzan

2022

JAMA

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Effects of local laser treatment on vulvovaginal atrophy among women with breast cancer: a prospective study with long-term follow-up

Cited by 24 publications

References 35 publications

Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

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

Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Vaginal Symptom Severity in Postmenopausal Women

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