FEMALE SEXUAL FUNCTION AFTER VAGINAL ERBIUM LASER: SINGLE CENTRE EXPERIENCE OF LONG-TERM EFFICACY


Chiara Nanini, Gian Luca Bracco, Giovanna Simi, Lorenzo Goglia, Simone Puccetti.
ASL Nord Ovest Toscana-Lucca

INTRODUCTION: Genitourinary Syndrome of Menopause (GSM) caused vaginal dryness and urinary incontinence. Some women have contraindications to estrogen therapy, so laser therapy can be an opportunity to alleviate GSM symptoms.
AIM OF THE STUDY: The aim of the study is to evaluate the long-term effectiveness of Er:YAG laser therapy on female sexual function.
MATERIALS AND METHODS: In this single-centre, non-randomized study we include patients affected by vulvovaginal atrophy and stress urinary incontinence. Assessment of incontinence severity is performed with the International Consultation on Incontinence Short Form (ICIQ-UI SF). The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) are administered to investigate sexual function and its impact on quality life. Clinical examination, valuation of FSFI score and FSDS score are performed 4 weeks, 3, 6, 12 or 24 months after the last laser medication.
RESULTS: In 2015, 13 patients affected by vaginal atrophy and 24 affected by urinary incontinence come to our Centre to undergo laser treatment. Considering patients with vulvovaginal atrophy, the FSFI score at the end of laser treatment is statistically significant higher than before treatment. The FSFI score after 2 years is lower than the score after the end of treatment but the FSFI score persist higher than baseline. The FSDS score at the end of treatment is statistically significant lower than before treatment. The FSDS score after 2 years is higher than the score after the end of treatment but the FSDS score persist lower than baseline. Women refer an improvement of GSM symptoms compared to the manifestation before, but a deterioration of wellness respect to the end of the procedure.
DISCUSSION: Our results show that the improvement is evident immediately after treatment and persists for 6 month after the procedure with a worsening during years. However the severity degree achieved after 2 years is inferior as compared to the situation before VEL.

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