Application of microablative fractional CO2-laser photothermolysis for correction of age-associated processes of vulvovaginal area
https://doi.org/10.21518/2079-701X-2019-7-8-12
Abstract
During the course of their lives, almost all women face pathological changes in the vulvovaginal area caused by various causes: dysplasia of connective tissue, excessive physical activity, childbirth, reduction of sex hormones, etc. Vulvovaginal symptoms have no significant impact on life expectancy and have a significant impact on the quality of life. In this regard, the modern possibilities of correction of these conditions, especially the minimally invasive ones, become especially important. The article discusses the methods of treatment and prophylaxis of age-associated pathological changes in the vulvovaginal area using a CO2-laser. Mechanisms of laser radiation influence on tissues are considered when using different modes. The advantages of microablative CO2-fraction laser photothermolysis in vaginal and vulva tissue rejuvenation programs are shown. The analysis of clinical studies on the use of lasers in the treatment of vulvovaginal diseases has been carried out, and tasks have been set for the development and implementation of highly effective and safe technologies in the practice of gynaecologists that affect the mucous membranes of the vagina and vulva, as well as a reliable assessment of their effectiveness.
About the Authors
I. A. Apolihina
Federal State Budgetary Institution «National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov» of the Ministry of Health of the Russian Federation; Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University).
Russian Federation
Russian Federation
Apolikhina Inna Anatolievna– Dr. of Sci. (Med), Professor, obstetrician-gynecologist of the highest category, physiotherapist, head of the Department of Aesthetic Gynecology and Rehabilitation; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductive Science at the Institute of Postgraduate Education.
117997, Russia, Moscow, 4, Oparina str.
8, Trubetskaya Street, Moscow, 119991, Russia, p. 2.
E. M. Nazimova
Dr. Nazimova’s Clinic.
Russian Federation
Russian Federation
Nazimova Evgeniya Mikhailovna – obstetrician-gynecologist, ultrasonic
diagnostics doctor, chief physician.
References
1. Звелто О. Принципы лазеров. СПб.: «Лань», 4-е изд., 2008. 720 с. [Zvelto. O. Laser principles. St. Petersburg: «Lan», 4th edition, 2008. 720 с.] (In Russ.)
2. Беликов А.В., Скрипник А.В. Лазерные биомедицинские технологии. СПб.: СПбГУ ИТМО, 2008. 116 с. [Belikov A.V., Skrypnik A.V. Laser biomedical technologies. St. Petersburg/: St. Petersburg State University ITMO, 2008. 116 p.] (In Russ.)
3. Карабут М.М., Гладкова Н.Д., Фельдштейн Ф.И., Киселева Е.Б., Фомина Ю.В., Мураев А.А. Применение фракционного лазерного фототермолиза в клинической практике. Современные технологии в медицине. 2010;4:115-121. [Karabut M.M., Gladkova N.D., Feldstein F.I., Kiseleva E.B., Fomina Yu.V., Murayev A.A.. Application of fractional laser photothermolysis in clinical practice. Modern technologies in medicine [Sovremennye tehnologii v medicine]. 2010;4:115-121.] (In Russ.)
4. Palacios S., Castelo-Branco C., Currie H., Mijatovic V., Nappi R.E., Simon J. et al. Update on management of genitourinary syndrome of menopause: A practical guide. Maturitas. 2015 Nov 1;82(3):308-313. https://doi.org/10.1016/j.maturitas.2015.07.020.
5. Аполихина И.А., Горбунова Е.А., Одинокова В.А. Малоинвазивные инновационные лазерные технологии в гинекологической практике. Акушерство и гинекология. 2014;11:17-22. [Apolihina I.A., Gorbunova E.A., Odinokova V.A. Low-invasive innovative laser technologies in gynecological practice. Obstetrics and gynecology [Akusherstvo i ginekologija]. 2014;11:17-22.] (In Russ.)
6. Zerbinati N., Serati M., Origoni M., Candiani M., Iannitti T., Salvatore S., et al. Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. Lasers in medical science. 2015 Jan;30(1):429-436. PubMed PMID: 25410301.
7. Stefano S., Stavros A., Massimo C. The use of pulsed CO2 lasers for the treatment of vulvovaginal atrophy. Current Opinion in Obstetrics and Gynecology. 2015;27(6):504–508.
8. Gaspar A., Brandi H., Gomez V., Luque D. Efficacy of Erbium: YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause. Lasers in Surgery and Medicine. 2017;49(2):160–168.
9. Salvatore S., Nappi R.E., Parma M., et al. Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. Climacteric. 2015;18:219–225.
10. Salvatore S., Stavros A., Massimo C. The use of pulsed CO2 lasers for the treatment of vulvovaginal atrophy. Curr Opin Obstet Gynecol. 2015;27:504–508.
11. Siliquini G.P., Tuninetti V., Bounous V.E., Bert F., Biglia N. Fractional CO2 laser therapy: a new challenge for vulvovaginal atrophy in postmenopausal women. Climacteric. 2017;20:379-384. doi: 10.1080/13697137.2017.1319815.
12. Archer D.F. Efficacy and tolerability of local estrogen therapy for urogenital atrophy. Menopause. 2010;17:194–203.
13. Filippini M., Del Duca E., Negosanti F., Bonciani D., Negosanti L., Sannino M., Cannarozzo G., Nisticò. Fractional CO2 Laser: From Skin Rejuvenation to Vulvo-Vaginal Reshaping. Photomedicine and Laser Surgery. 2017;35:1-5. doi: 10.1089/pho.2016.4173.
14. Sturdee D.W., Panay N. International Menopause Society Writing Group. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13:509–522.
15. FDA. FDA warns against use energy-based devices to perform vaginal «rejuvenation» or vaginal cosmetic procedures: FDA Safety Communication. 2018. [2018 August 1].
16. Abbas Shobeiri S., Kerkhof M.H., Vatche A. Minassian, Bazi T. IUGA committee opinion: laserbased vaginal devices for treatment of stress urinary incontinence, genitourinary syndrome of menopause, and vaginal laxity. International Urogynecology Journal. 2019;30(3):371–376. doi: 10.1007/s00192-018-3830-0.
17. Garcia B., Pardo J. Academic cosmetic gynecology and energy-based therapies: ambiguities, explorations, and FDA advisories. International Urogynecology Journal. 2019;30:1–2. doi: 10.1007/s00192-018-3812-2
Review
For citations:
Apolihina IA, Nazimova EM. Application of microablative fractional CO2-laser photothermolysis for correction of age-associated processes of vulvovaginal area. Meditsinskiy sovet = Medical Council. 2019;(7):8-12. (In Russ.) https://doi.org/10.21518/2079-701X-2019-7-8-12
Views:
1315
Email this article 