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Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment

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Abstract

Vaginal atrophy occurring during menopause is closely related to the dramatic decrease in ovarian estrogens due to the loss of follicular activity. Particularly, significant changes occur in the structure of the vaginal mucosa, with consequent impairment of many physiological functions. In this study, carried out on bioptic vaginal mucosa samples from postmenopausal, nonestrogenized women, we present microscopic and ultrastructural modifications of vaginal mucosa following fractional carbon dioxide (CO2) laser treatment. We observed the restoration of the vaginal thick squamous stratified epithelium with a significant storage of glycogen in the epithelial cells and a high degree of glycogen-rich shedding cells at the epithelial surface. Moreover, in the connective tissue constituting the lamina propria, active fibroblasts synthesized new components of the extracellular matrix including collagen and ground substance (extrafibrillar matrix) molecules. Differently from atrophic mucosa, newly-formed papillae of connective tissue indented in the epithelium and typical blood capillaries penetrating inside the papillae, were also observed. Our morphological findings support the effectiveness of fractional CO2 laser application for the restoration of vaginal mucosa structure and related physiological trophism. These findings clearly coupled with striking clinical relief from symptoms suffered by the patients before treatment.

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Acknowledgments

NZ, MS, MO, MC, TI, SS, FM and AC contributed equally to this work. Many thanks to Aurora Farina for her skillful technical contribution. This article was not supported by grants.

Conflict of interest

NZ, MS, MO, MC, TI, SS, FM and AC certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Statement of authorship

NZ, MS, MO, MC, TI, SS, FM and AC hereby certify that all work contained in this article is original. The authors claim full responsibility for the content of this article.

Informed consent

Written informed consent was obtained from the patients participating in this study.

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Authors and Affiliations

  1. Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy

    Nicola Zerbinati

  2. Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy

    Maurizio Serati

  3. Department of Gynecology, IRCCS San Raffaele Hospital, Milano, Italy

    Massimo Origoni, Massimo Candiani & Stefano Salvatore

  4. School of Biomedical Sciences, University of Leeds, Mount Preston Street, Garstang building,, Leeds, LS2 9JT, UK

    Tommaso Iannitti

  5. ReGenera Research Group for Aging Intervention, Milan, Italy

    Francesco Marotta

  6. Department of Public Health, Experimental and Forensic Medicine, Histology and Embryology Unit, University of Pavia, Pavia, Italy

    Alberto Calligaro

Authors
  1. Nicola Zerbinati
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  2. Maurizio Serati
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  3. Massimo Origoni
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  4. Massimo Candiani
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  5. Tommaso Iannitti
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  6. Stefano Salvatore
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  7. Francesco Marotta
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  8. Alberto Calligaro
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Corresponding author

Correspondence to Tommaso Iannitti.

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Zerbinati, N., Serati, M., Origoni, M. et al. Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. Lasers Med Sci 30, 429–436 (2015). https://doi.org/10.1007/s10103-014-1677-2

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  • DOI: https://doi.org/10.1007/s10103-014-1677-2

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