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The following is a summary of “Efficacy of Fractionated Carbon Dioxide Laser for the Treatment of Genitourinary Syndrome of Menopause,” published in the March 2025 issue of Obstetrics & Gynecology by Vizán-Chaguaceda et al.
Researchers conducted a retrospective study to assess the short-term effectiveness of fractional CO2 laser in treating genitourinary syndrome of menopause.
They included studies that met specific criteria: exclusively involved women diagnosed with genitourinary syndrome of menopause, had at least 1 group receiving fractional CO2 laser treatment, used a control group receiving simulated fractional CO2 laser therapy, topical hormonal treatment, or a topical gel lubricant, assessed outcomes related to sexual function, urinary symptoms, or vaginal epithelium quality, and followed a randomized controlled trial design. The exclusion criterion ruled out participants with a history of any cancer or prior treatment with a different type of laser.
They independently screened articles for eligibility and extracted data. The between-group difference in means was calculated using the difference in mean differences and 95% CIs, divided by the pooled SD. The I2 statistic assessed heterogeneity. The review included 11 articles, each with a group receiving fractional CO2 laser therapy and a control group receiving simulated fractional CO2 laser, topical hormonal treatment, or topical gel lubricant.
The results showed that fractional CO2 laser effectively improved sexual function by enhancing sexual desire, arousal, lubrication, orgasms, and satisfaction. It significantly reduced pain during sexual activity (standardized mean difference 0.51, P=.021) and improved urinary function by decreasing urinary leakage frequency and severity, as well as reducing urination frequency (standardized mean difference 0.51, P <.001).
Investigators concluded the fractional CO2 laser led to short-term improvements in sexual and urinary symptoms but not vaginal epithelium quality, and the clinical relevance of the changes remained uncertain.
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