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Climacteric. 2016 Oct;19(5):512-8. doi: 10.1080/13697137.2016.1212006. Epub 2016 Aug 24.

The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women.

Author information

1
a Urogynecology Unit, 1st Department of Obstetrics and Gynecology , "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece ;
2
b Alpha Institute of Biomedical Sciences (AIBS) , Athens , Greece ;
3
c Microbiology Department , "G. Gennimatas" General Hospital , Athens , Greece ;
4
d Obstetrics and Gynecology Unit , Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital , Milan , Italy Urogynecology Unit ;
5
e Department of Medicine-Infectious Diseases , IASO General Hospital , Athens , Greece ;
6
f Department of Medicine , Tufts University School of Medicine , Boston, MA , USA.

Abstract

OBJECTIVES:

To assess the effect of microablative fractional CO2 laser (MFCO2-Laser) therapy on the vaginal microenvironment of postmenopausal women.

METHODS:

Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear <5%. Vaginal fluid pH values, fresh wet mount microscopy, Gram stain and aerobic and anaerobic cultures were evaluated at baseline and 1 month after each subsequent therapy. Nugent score and Hay-Ison criteria were used to evaluate vaginal flora.

RESULTS:

Fifty-three women (mean age 57.2 ± 5.4 years) participated and completed this study. MFCO2-Laser therapy increased Lactobacillus (p < 0.001) and normal flora (p < 0.001) after the completion of the therapeutic protocol, which decreased vaginal pH from a mean of 5.5 ± 0.8 (initial value) to 4.7 ± 0.5 (p < 0.001). The prevalence of Lactobacillus changed from 30% initially to 79% after the last treatment. Clinical signs and symptoms of bacterial vaginosis, aerobic vaginitis or candidiasis did not appear in any participant.

CONCLUSION:

MFCO2-Laser therapy is a promising treatment for improving the vaginal health of postmenopausal women by helping repopulate the vagina with normally existing Lactobacillus species and reconstituting the normal flora to premenopausal status.

KEYWORDS:

UTIs; Vaginal atrophy; dyspareunia; intravaginal therapy; menopause; urinary tract infections; urogenital infections; vaginitis

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