Re: Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham-controlled trial

Laser versus sham for genitourinary syndrome of menopause: A randomised controlled trial

OBJECTIVE

To assess whether CO2 laser treatment is more effective than sham application in relieving the most bothersome symptom (MBS) in women with genitourinary syndrome of menopause (GSM).

DESIGN

Single-centre, sham-controlled, double-blind, randomised trial.

SETTING

A tertiary centre in Belgium.

POPULATION

Sixty women with moderate to severe GSM symptoms.

METHODS

All participants eventually received three consecutive laser and three consecutive sham applications, either first laser followed by sham, or conversely.

MAIN OUTCOME MEASURES

The primary outcome was the participant-reported change in severity of the MBS at 12 weeks. Secondary outcomes included subjective (patient satisfaction, sexual function, urinary function) and objective (pH, Vaginal Health Index Score, in vivo microscopy) measurements assessing the short-term effect and the longevity of treatment effects at 18 months after start of the therapy. Adverse events were reported at every visit.

RESULTS

The MBS severity score decreased from 2.86 ± 0.35 to 2.17 ± 0.93 (-23.60%; 95% CI -36.10% to -11.10%) in women treated with laser compared with 2.90 ± 0.31 to 2.52 ± 0.78 (-13.20%; 95% CI -22.70% to -3.73%) in those receiving sham applications (p = 0.13). There were no serious adverse events reported up to 18 months.

CONCLUSIONS

In women with GSM, the treatment response 12 weeks after laser application was comparable to that of sham applications. There were no obvious differences for secondary outcomes and no serious adverse events were reported.