Journal article
The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document
Neurourology and urodynamics, Vol.38(3), pp.1009-1023
03/2019
DOI: 10.1002/nau.23931
PMID: 30742321
Abstract
The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology is controversial. 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. This project was developed between January and September 2018. The development of this document followed the ICS White Paper Standard Operating Procedures. 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 studies are industry sponsored. Due to 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 following 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, while short-term complications seem to be uncommon, data concerning long-term outcomes are lacking. 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 - Department of Urogynaecology, Imperial College Healthcare, London, UKCarol Emi Bretschneider - Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OhioMargot Damaser - Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OhioOktay Demirkesen - Faculty of Medicine, Department of Urology, Istanbul University Cerrahpaşa, Istanbul, TurkeyDebra S Heller - Department of Pathology and Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New JerseyNaside Mangir - Department of Urology, Royal Hallamshire Hospital, Sheffield, UKClaudia Marchitelli - Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaSherif Mourad - Department of Urology, Massachusetts General Hospital-Harvard Medical School Boston, Boston, MassachusettsMicheline Moyal-Barracco - Department of Dermatology, Hôpital Tarnier-Cochin, Paris, FranceSol Peremateu - Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaVisha Tailor - Department of Urogynaecology, Imperial College Healthcare, London, UKTufan Tarcan - Department of Urology, Ain Shams University, Cairo, EgyptElise J B De - Department of Urology, Marmara University School of Medicine, Istanbul, TurkeyColleen K Stockdale - Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Neurourology and urodynamics, Vol.38(3), pp.1009-1023
- DOI
- 10.1002/nau.23931
- PMID
- 30742321
- NLM abbreviation
- Neurourol Urodyn
- ISSN
- 1520-6777
- eISSN
- 1520-6777
- Publisher
- United States
- Language
- English
- Date published
- 03/2019
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9983931744402771
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