Zeyneb BAKACAK

Postmenopozal Vulvovajinal Atrofi Saptanan Kadınlarda Fraksiyonel CO2 Lazer (Femilift™) Tedavisinin Etkinliği: Türkiye'den Tek Bir Merkezin Ön Sonuçları

Amaç: Etyolojisinde hipoöstrojenemi olan Vulvovajinal atrofiye (VVA) bağlı gelişen vajinal laksite, kuruluk, disparoni, kaşıntı, yanma, idrar kaçırma gibi semptomlar postmenopozal kadınlar arasında sık görülen ve yaşam kalitesini azaltan durumlardır. Bu çalışmamızda bu olgularda uyguladığımız CO2 lazer tedavisinin etkinliğini ve bu tür tedaviyle ilgili olası yan etkileri değerlendirmeyi amaçladık. Gereç ve Yöntemler: 48-72 yaş arasında VVA şikayetleri olan ve buna yönelik 4-6 hafta ara ile toplam 3 seans CO2 lazer tedavisi uyguladığımız 30 hastanın klinik muayene ve tedavi kayıtları retrospektif olarak incelenmiştir. Tüm hastaların ilk lazer seansından önce ve son seanstan 4 hafta sonra VVA semptomları görsel analog skala (VAS) kullanılarak değerlendirilmişti. Bulgular: Olguların VVA semptomları olarak kuruluk, ağrılı cinsel ilişki, vaginal yanma, kaşıntı ve vajinal introitus ağrısı açısından VAS skorları değerlendirildiğinde her 5 semptom için de tedavi sonrası skorlarda istatistiksel olarak anlamlı düzeyde düşüşler tespit edilmiştir. Sonuç: VVA şikayetleri olan ileri yaş olgulara yönelik yapılan CO2 lazer tedavisi şikayetlerde kayda değer oranda yan etki görülmeden anlamlı düzeyde azalma sağlar. Böylece uzun süreli lokal östrojen kremleri kullanmak istemeyen ve meme ve genital jinekolojik kanser geçmişi olup lokal östrojen kullanması kontrendike olan hastalarda güvenilir bir alternatif olabilir.

Anahtar Kelimeler:

Vulvovaginal atrofi, CO2 lazer tedavisi, Hipoöstrojenemi, Postmenopozal kadınlar

The efficacy of fractional CO2 laser (FemiLift™) treatment in postmenopausal females with vulvovaginal atrophy: Preliminary results from a single center in Turkey

Objective: Symptoms, such as vaginal laxity, dryness, dyspareunia, itching, burning, and urine leakage, associated with vulvovaginal atrophy (VVA) with hypo-osteogenesis etiology, are frequently seen in postmenopausal females, and they diminish quality of life. This study aimed to evaluate the efficacy of CO2 laser treatment in these cases and to evaluate the potential side-effects related to this type of treatment. Materials and Methods: A retrospective examination was made of the clinical examination and treatment records of 30 patients, aged 48–72 years, who presented with VVA complaints and underwent CO2 laser treatment for a total of three sessions at intervals of 4–6 weeks. The VVA symptoms of all the patients were evaluated using a Visual Analog Scale (VAS) before the first laser session and 4 weeks after the final session. Results: The VVA symptoms of dryness, painful sexual relations, vaginal burning, itching, and vaginal introitus pain were evaluated with VAS scores; a statistically significant reduction was determined in all five symptoms after CO2 laser treatment. Conclusion: A significant reduction was obtained in the VVA complaints with no significant side-effects following the application of CO2 laser treatment for VVA cases in the postmenopausal females. Thus, this treatment can be considered to a reliable alternative for patients who do not wish to use local estrogen creams long-term, those with a history of breast or gynecological cancer, and those with contra-indications for the use of local estrogen.

Keywords:

Vulvovaginal atrophy, CO2 laser treatment, Hypo-oestrogenemia, Postmenopausal females,

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