An initial report on the use of LASER in Australian women
Dr Jean O'Riordan (1), Sr Julie Edwards (1), Dr Elizabeth Dally (1)
(1) South Coast Urology, Wollongong, Australia
Laxity of the female vaginal wall due to changes in connective tissue is a part of the normal ageing process. This however, compounded by pregnancies, deliveries and menopause can lead to vaginal atrophy and other ensuing consequences, such as stress urinary incontinence, pelvic organ prolapse, altered sexual function, pain and recurrent urinary tract infections. The traditional management options of behavioural changes and pharmacologic treatments are safe but can be disappointing, while surgical options have better success rates but are considered more invasive and more risky. Furthermore, surgical options have become more limited by recent mesh controversies. Vaginal LASER therapy is a novel treatment for the management of these patients who have failed conservative measures and who do not want to embark on more invasive options. It works by inducing collagen remodelling and new production of collagen in the vaginal mucosal tissue and the introitus. There is however, a paucity of clinical research to support its widespread use.
We present our initial data on 25 patients treated at our multidisciplinary clinic in Wollongong with the Fotona Er:YAG 2940 nm vaginal LASER for varying indications.All completed pre and post-treatment quality-of-life questionnaires and pad weight tests. All treatments were performed in the clinic under local anaesthesia only.
We present our results in terms of safety and efficacy. Two patients had an unsatisfactory clinical response, and 1 of these has had further surgery. One patient who initially responded well has had a recurrence of her symptoms after 12 months but all others were satisfied.
In our practice, vaginal LASER treatment offers a non-invasive, safe, ambulatory, well-tolerated and efficacious treatment option for this cohort of patients. Further studies on long-term safety and outcomes are required.