Journal article
The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: An ICS/ISSVD Best Practice Consensus Document
Journal of lower genital tract disease, Vol.23(2), pp.151-160
04/2019
DOI: 10.1097/LGT.0000000000000462
PMCID: PMC6462818
PMID: 30789385
Abstract
In this best practice document, we propose recommendations for the use of LASER for gynecologic and urologic conditions such as vulvovaginal atrophy, urinary incontinence, vulvodynia, and lichen sclerosus based on a thorough literature review. Most of the available studies are limited by their design; for example, they lack a control group, patients are not randomized, follow-up is short term, series are small, LASER is not compared with standard treatments, and most studies are industry sponsored. Because of these limitations, the level of evidence for the use of LASER in the treatment of these conditions remains low and does not allow for definitive recommendations for its use in routine clinical practice. Histological evidence is commonly reported as proof of tissue regeneration after LASER treatment. However, the histological changes noted can also be consistent with reparative changes after a thermal injury rather than necessarily representing regeneration or restoration of function. The use of LASER in women with vulvodynia or lichen sclerosus should not be recommended in routine clinical practice. There is no biological plausibility or safety data on its use on this population of women. The available clinical studies do not present convincing data regarding the efficacy of LASER for the treatment of vaginal atrophy or urinary incontinence. Also, although short-term complications seem to be uncommon, data concerning long-term outcomes are lacking. Therefore, at this point, LASER is not recommended for routine treatment of the aforementioned conditions unless part of well-designed clinical trials or with special arrangements for clinical governance, consent, and audit.
Details
- Title: Subtitle
- The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: An ICS/ISSVD Best Practice Consensus Document
- Creators
- Mario Preti - Department of Obstetrics and Gynecology, University of Torino, Torino, ItalyPedro Vieira-Baptista - Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, PortugalGiuseppe Alessandro Digesu - Imperial College Healthcare, Department of Urogynaecology, London, UKCarol Emi Bretschneider - Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland ClinicMargot Damaser - Advanced Platform Technology Center Louis Stokes Cleveland VA Medical Center, Cleveland, OHOktay Demirkesen - Istanbul University Cerrahpaşa Faculty of Medicine, Department of Urology, Istanbul, TurkeyDebra S Heller - Department of Pathology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJNaside Mangir - Royal Hallamshire Hospital, Department of Urology, Sheffield, UKClaudia Marchitelli - Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaSherif Mourad - Ain Shams University, Department of Urology, Cairo, EgyptMicheline Moyal-Barracco - Department of Dermatology, Hôpital Tarnier-Cochin, Paris, FranceSol Peremateu - Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaVisha Tailor - Imperial College Healthcare, Department of Urogynaecology, London, UKTufan Tarcan - Marmara University School of Medicine, Department of Urology, Istanbul, TurkeyElise J B De - Department of Urology, Massachusetts General Hospital-Harvard Medical School Boston, MAColleen K Stockdale - Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of lower genital tract disease, Vol.23(2), pp.151-160
- DOI
- 10.1097/LGT.0000000000000462
- PMID
- 30789385
- PMCID
- PMC6462818
- NLM abbreviation
- J Low Genit Tract Dis
- ISSN
- 1089-2591
- eISSN
- 1526-0976
- Publisher
- United States
- Grant note
- F9261-L / ORD VA
- Language
- English
- Date published
- 04/2019
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9983931763302771
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