The beneficial effects of fractional CO2 laser treatment on perineal changes during puerperium and breastfeeding period: a multicentric study

Luvero, Daniela; Filippini, Maurizio; Salvatore, Stefano; Pieralli, Annalisa; Farinelli, Miriam; Angioli, Roberto

doi:10.1007/s10103-020-03212-x

Cited by 3 publications

(13 citation statements)

References 17 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%

“…In this review, 99 studies including 51 094 patients provided no information on severe adverse events (SAE) related to using LASER as a vaginal or vulvar treatment 23–42,44,45,47–50,52–70,72–78,80–85,87–92,94–106,108,110–124,128–131,133,135 . Eleven studies gave no information on SAE or AEs 43,46,51,71,79,86,93,107,109,126,132 .…”

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%

Section: Resultsmentioning

confidence: 99%

See 3 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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Genitourinary syndrome of lactation: a new perspective on postpartum and lactation-related genitourinary symptoms

Perelmuter,

Burns,

Shearer

et al. 2024

Sexual Medicine Reviews

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Background The genitourinary syndrome of menopause (GSM) is a well-documented condition characterized by a range of genitourinary symptoms in peri- and postmenopausal women. As with GSM, postpartum lactating women experience reduced estrogen and androgen levels. However, there is limited research on the impact of symptoms during the postpartum breastfeeding period. Objectives The aim was to review the literature for genitourinary health in the postpartum breastfeeding population and summarize key findings and potential treatments. Methods We performed a comprehensive literature review in PubMed, Google Scholar, and Scopus from inception of database to November 2023 using the following keywords individually and in combination: “physiology of postpartum” or “physiology of lactogenesis” or “vulvovaginal health” or “vaginal atrophy” or “vaginal dryness” or “dyspareunia” or “urinary incontinence” or “lactation” or “breastfeeding” or “vaginal estrogen.” All identified articles published in English were considered. Relevant studies were extracted, evaluated, and analyzed. The work presented in this article represents a summative review of the identified literature. Results During lactation, high levels of prolactin inhibit estrogen and androgen secretion via negative feedback, which leads to an increased prevalence of vulvovaginal atrophy, vaginal dryness, dyspareunia, and urinary incontinence in lactating postpartum women. Despite these highly prevalent and potentially devastating symptoms, there is a lack of consistent screening at postpartum visits and no treatment guidelines available to health care providers. Conclusion Postpartum breastfeeding women experience similar physiology and symptoms to the postmenopausal phase, as seen in GSM. We propose the introduction of a novel term to describe the genitourinary changes seen in postpartum breastfeeding individuals: genitourinary syndrome of lactation. The diagnostic use of genitourinary syndrome of lactation will equip health care providers with an all-encompassing term to bring awareness to the symptoms experienced by postpartum breastfeeding individuals and lead to improved screening and treatment for the high numbers of individuals experiencing these genitourinary changes.

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Unraveling the parameters and biological mechanisms of CO2 laser therapy for acute pain relief

Wang,

Liu,

Wang

et al. 2023

Front. Neurol.

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Acute pain-related pathology is a significant challenge in clinical practice, and the limitations of traditional pain-relief drugs have made it necessary to explore alternative approaches. Photobiomodulation (PBM) therapy using CO2 laser has emerged as a promising option. In this study, we aimed to identify the optimal parameters of CO2 laser irradiation for acute pain relief through in vivo and in vitro experiments. First, we validated the laser intensity used in this study through bone marrow mesenchymal stem cells (BMSCs) experiments to ensure it will not adversely affect stem cell viability and morphology. Then we conducted a detailed evaluation of the duty cycle and frequency of CO2 laser by the hot plate and formalin test. Results showed a duty cycle of 3% and a frequency of 25 kHz produced the best outcomes. Additionally, we investigated the potential mechanisms underlying the effects of CO2 laser by immunohistochemical staining, and found evidence to suggest that the opioid receptor may be involved in its analgesic effect. In conclusion, this study provides insights into the optimal parameters and underlying mechanisms of CO2 laser therapy for effective pain relief, thereby paving the way for future clinical applications.

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The beneficial effects of fractional CO2 laser treatment on perineal changes during puerperium and breastfeeding period: a multicentric study

Cited by 3 publications

References 17 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

Genitourinary syndrome of lactation: a new perspective on postpartum and lactation-related genitourinary symptoms

Unraveling the parameters and biological mechanisms of CO2 laser therapy for acute pain relief

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