Терапия вульвовагинальной атрофии СО2-лазером

Up to 96% of women experience one or more symptoms of vulvovaginal atrophy – dryness, itching, burning, unpleasant or painful sensations during intercourse, concomitant changes in the physiological pH level and recurrent infections of the genitourinary system.

Most often, patients are concerned about problems after childbirth or during menopause, and to solve them Dr. Andreas-Simon Lenhard (Andreas-Simon Lenhard) often resorts to CO2- laser, which is described in this article estet-portal.com.

Possibilities of CO2-lasers in aesthetic medicine

Due to their efficiency and versatility, CO2-lasers are widely used not only for aesthetic, but also for therapeutic purposes. Specialists have developed protocols for various procedures based on laser systems to improve the face and body, which include the treatment of vulvovaginal atrophy.

Read also: Use of CO2-lasers in rejuvenation of the periorbital zone

In his clinic, Dr. Lenhard uses the system CO2RE Intima, which allows for a full range of CO2 laser therapy procedures – from fractional facial rejuvenation to full ablative, surgical procedures. The system is lightweight and portable.

Preparation for Vulvovaginal Atrophy Laser Therapy

Female patients who respond in writing to standard questions about vulvovaginal atrophy most often complain about:

  • itching, burning and pain during intimacy;
  • loss of sensation in the vagina.

Women after childbirth often supplement the above list of symptoms with the expansion of the vaginal canal.  

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VVA symptoms – symptoms of vulvovaginal atrophy;

Itching – itching;

Burning – burning;

Dryness

– dryness;

Dyspareunia

– dyspareunia. 

Fig. 1: symptoms of vulvovaginal atrophy and/or vaginal laxity/stress urinary incontinence grade 1 before and after three sessions of CO2 laser therapy (248 patients aged 41–74 years) After receiving detailed information about the CO

2

-laser therapy procedure, the patients give informed consent to it. Common symptoms of vulvovaginal atrophy: itching, burning, recurrent genitourinary infections, discomfort during intercourse.

Before the procedure, a
vaginal examination

is performed, during which the doctor excludes infections, wounds and other contraindications for laser correction.

Peculiarities of modern use of laser treatment If during the procedure the doctor will need to work with a laser on the external genital organs, the hair from the target

th zone will be removed beforehand. CO

2

-laser therapy: how the procedure works 20 minutes prior to laser exposure,

hydrophobic cream of prilocaine

or xylocaine. is applied to the labia majora and labia minora.

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Facebook! During the manipulations, the patient is in the gynecological chair in protective glasses designed for use with CO2 lasers.

The vaginal canal is cleaned with a cotton swab to remove excess fluid from the treated area.

liquid paraffin oil

is used to lubricate the labia and disposable applicator. The applicator is mounted on a 360-degree swivel lens and inserted to a predetermined depth. Standard

settings for

Intima CO2RE:

fractional effect 5%;
  • 50 mJ;
  • 396 J/cm
    • 2
  • .
    • From the 12 o'clock position, the applicator is rotated 30 degrees clockwise and the laser beam is applied to the target area. Thus, for a full revolution of the applicator, 12 beams are delivered. After that, the applicator is withdrawn 1 cm and another pass is made through the vaginal canal.

The procedure is painless, however, the patient may experience mild discomfort in the outer third of the vaginal canal.

After use, the applicator is discarded and the handle and lens are placed on the device to treat the vulva.

Laser rejuvenation of the intimate area: features of an effective procedure Before starting CO

2

-laser therapy, it is important to remove excess oil and anesthetic cream. The labia majora and minora are treated with adjacent laser beams up to the level of the hymenal ring

a. Results of CO

2

-laser therapy for vulvovaginal atrophy and post-procedure care

After laser therapy

of the vulvovaginal area, the doctor prescribes to patients:

Hyaluronic acid capsules to be taken for 14 days;
  • A hyaluronic acid gel to be applied to the vulva twice a day for two weeks.
    • Maximum results appear after 3–5 treatments. The patient returns to the doctor for a follow-up visit 4 weeks after the first therapy session.

Maximum results appear after 3–5 sessions.

After a year, it is recommended to have a
maintenance procedure

.

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A 32-year-old female patient (2 pregnancies, 2 EP) with labia hypertrophy, vaginal laxity, and grade 1 stress urinary incontinence before and after laser labioplasty and clitoral hood reduction and three sessions of

CO2RE Intima. The patient is completely satisfied with the results of the correction If

surgery

is required to remove excess skin, it will be done 6 weeks before the Intima procedure. Adapted from

The

PMFA Journal.