Microablative CO2 laser therapy and oral adjuvants in genito-urinary syndrome, effectiveness outcomes: a pilot study

ABSTRACT

Objective. Genitourinary syndrome is a complex of multi-organ symptoms related to hypoestrogenism. Over 50% of women in menopause are affected by severe symptoms thus the need for new therapeutic approaches. The objective of the study is to demonstrate whether oral integration of bioactive substances in CO₂ laser therapy can enhance the therapeutic effects of genitourinary syndrome.

Materials and Methods. The study conducted is a pilot study of a prospective monocentric case-control type. Sixty patients were recruited and a simple single-blind randomization was conducted to form two homogeneous groups. Half of the patients (group A) underwent CO₂ laser therapy vaginally and received placebo, while the second half (group B) underwent laser therapy and received oral supplementation with hyaluronic acid. Three treatments were administered monthly to each study group. The primary endpoint was the improvement in PISQ-12 scores from the baseline to the six-month follow-up. Secondary endpoints at six months were assessed with a symptom severity scale, PFSQ-7, I-QOL and Vaginal Health Index.

Results. Both groups showed an improvement according to the scores PISQ 12, PISQ 7, Vaginal Health Index (VHI) and Symptom score regarding itching, burning and dyspareunia. Group B achieved greater improvements with statistically significant differences (p < 0.05).

Conclusions. The CO₂ laser therapy represents a valid non-hormonal alternative in the treatment of genitourinary syndrome. Oral adjuvant therapies with hyaluronic acid can enhance the effectiveness of vaginal laser therapy.