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001-es BibID:	BIBFORM084853
Első szerző:	Kozma Bence (szülész-nőgyógyász)
Cím:	The effects of fractional CO2 laser treatment on the symptoms of pelvic floor dysfunctions and vulvovaginal atrophy / Kozma Bence, Takács Péter, Sipos Attila Gergely, Póka Róbert
Dátum:	2018
ISSN:	0937-3462
Megjegyzések:	Introduction: Vaginal laser treatment became a popular treatment modality for genitourinary syndrome of menopause. However scientific data is limited regarding the effects of laser treatment on different pelvic floor dysfunctions. Objectives: To evaluate the effect of the Mona Lisa Touch CO2 laser treatment on postmenopausal women vulvovaginal and pelvic floor dysfunction symptoms. Methods: Forty-three postmenopausal women were enrolled and underwent vaginal laser treatment with. Mona Lisa Touch. Patients received three vaginal laser treatments with the 360 degree probe 4-6 weeks apart. Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), Colorectal?Anal Distress Inventory 8 (CRADI-8) and Urinary Distress Inventory 6 (UDI-6) validated questionnaires were filled out by each patient before each session and 4 weeks after the final treatment. Vaginal Health Index (Elasticity, Fluid Secretion, pH, Epithelial mucosa, Moisture) was calculated before each session and 4 weeks after the final treatment. In addition, patients were asked to fill out a Visual Analog Scale (1-10, lower scores indicates less bother) on vaginal pain, dryness, burning, itching, dyspareunia and dysuria. Paired ttest was used to compare the before and after treatment results. Results: All patients were in menopause. The average age was 57?10 years. POPD-6 standardized scores were not significantly different after the first treatment (20 ?19 vs. 14?11 after the first treatment). But after the second treatment there was a significant improvement in the standardized score to 11?12 ( P=0.02). After the third treatment the score was even lower 10?13 (P=0.01). CRADI-8 standardized scores did not change significantly after three laser treatment (16 ?18 vs. 13?17 after the 1st treatment/13?16 after the 2nd treatment/ 12?18 after the 3rd treatment). UDI-6 standardized scores were not significantly different after the first laser treatment (32?23 vs. 26?23 after the first treatment). But after the second treatment there was a significant improvement in the standardized score to 25 ? 20 ( P=0.03). The Vaginal Health Index was 15?5 before and 17?4 after the first treatment, 19?5 after the second and 21?4 after the third treatment. VHI was significantly improved after each treatment (P<0.01). The largest incremental change occurred in vaginal moisture, followed by vaginal fluid and elasticity. The patient reported combined Visual Analog Score (VAS) was 16?16 before and 9?12 after the first treatment, 6 ? 9 after the second and 3 ? 8 after the third treatment. VAS was significantly lower (P<0.01) after each laser treatment. The largest improvement occurred after the first laser treatment, but each additional treatment added additional symptoms relief. Conclusion: CO2 vaginal laser treatment significantly improves patient reported urinary and pelvic organ prolapse bother. The minimum of two laser treatments were needed to achieve a significant benefit. In addition, CO2 vaginal laser treatment significantly improves both the patient reported subjective symptoms and the Vaginal Health Index in postmenopausal women even after a single laser treatment.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idézhető absztrakt folyóiratcikk
Megjelenés:	International Urogynecology Journal. - 29 : S1 (2018), p. 174. -
További szerzők:	Takács Péter (1968-) (szülész-nőgyógyász) Sipos Attila Gergely (1990-) (szülész-nőgyógyász) Póka Róbert (1960-) (szülész-nőgyógyász, klinikai onkológus)
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