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Safety and efficacy of non-ablative CO2 laser treatment of vulvo-vaginal atrophy in women with history of breast cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Breast cancer survivors (BCS) suffer severe vulvo-vaginal atrophy (VVA) and some of the most effective therapies are contraindicated. In literature we have no data about the non-ablative CO2 laser on these women. The aim of this study was to examine its efficacy, safety and acceptability in BCS.

Materials and methods

The enrolled women underwent 3 sessions of laser therapy (t0, t1, t2) and a one-month follow up examination (t3). At each time point we measured objective signs of VVA via VHI (Vaginal Health Index) and VuHI (Vulvar Health Index) and subjective parameters (Dryness, Burning, Itching, Dysuria) via visual analog scales (VAS). In sexually active women we evaluated the sexual function with FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Score) scores and MENQOL (menopause quality of life questionnaire).

Results

We enrolled 26 BCS. The mean VHI, VuVHI, dryness and burning VAS scores improved significantly and this improvement was not influenced by the initial VVA grade. MENQOL sexual domain, Lubrication, Orgasm and Pain domains and FSFI total score improved significantly, while Desire, Arousal and Satisfaction domains of FSFI and FSDS did not. At t0 women using Aromatase Inhibitors suffered more severe vaginal dryness than women using Tamoxifen or no therapy, but the three subgroups improved without differences. No adverse event and minimum discomfort were reported.

Conclusions

The non-ablative CO2 laser is a safe and effective treatment of VVA and has positive effects on sexual function in BCS regardless the use of adjuvant therapies and the initial grade of VVA.

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Data availability

The data that support the findings of this study are available from the corresponding author, AL, upon reasonable request.

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Acknowledgements

We thank Julie Norbury for manuscript language editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy

    Alessandra Lami, Stefania Alvisi, Veronica Amati, Renato Seracchioli & Maria Cristina Meriggiola

  2. Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy

    Alessandra Lami, Stefania Alvisi, Maurizio Baldassarre, Sara Zanella, Veronica Amati, Renato Seracchioli & Maria Cristina Meriggiola

  3. Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy

    Maurizio Baldassarre & Maria Cristina Meriggiola

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  1. Alessandra Lami
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  7. Maria Cristina Meriggiola
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Contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by AL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. AL, MCM: validation, writing—reviewing and editing, visualization. AL, MB, SZ: data curation, formal analysis. AL: writing—original draft preparation. AL, SA, VA: investigation. MCM, RS: supervision.

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Correspondence to Alessandra Lami.

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All authors report no conflict of interest for this work. This manuscript was not presented in any format at a national meeting nor an abstract was published from this study.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of S. Orsola-Malpighi University Hospital of Bologna (IRCCS).

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Informed consent was obtained from all individual participants included in the study.

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Lami, A., Alvisi, S., Baldassarre, M. et al. Safety and efficacy of non-ablative CO2 laser treatment of vulvo-vaginal atrophy in women with history of breast cancer. Arch Gynecol Obstet 309, 1575–1583 (2024). https://doi.org/10.1007/s00404-023-07323-y

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