Fractional erbium laser in vaginal laxity

Trisniartami Setyaningrum; Brahmana Askandar Tjokroprawiro; M Yulianto Listiawan; Budi Santoso; Cita Rosita Sigit Prakoeswa

doi:10.15562/bmj.v%vi%i.2594

Fractional erbium laser in vaginal laxity

Trisniartami Setyaningrum ,

Brahmana Askandar Tjokroprawiro ,

M Yulianto Listiawan ,

Budi Santoso ,

Cita Rosita Sigit Prakoeswa ,

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DOI: https://doi.org/10.15562/bmj.v%25vi%25i.2594 |
Published: 2021-08-30

Abstract

Vaginal laxity is a condition that often occurs in women, especially after vaginal delivery, and its prevalence increases with age. This review aimed to explain the role of fractional Erbium laser as a new modality for vaginal laxity management. The typical symptom reported by patients was reduced vaginal sensation. One therapeutic option for vaginal laxity is fractional Erbium laser: yttrium aluminum garnet (Er: YAG) at 2,940 nm frequencies. The laser's thermal stimulation of the dermis appears to stimulate the formation of new collagen, resulting in the thickening of the vaginal mucosa. Previous studies on Er: YAG fractional lasers have shown satisfactory results with minimal side effects.

References

Manzini C, Friedman T, Turel F, Dietz HP. Vaginal laxity: which measure of levator ani distensibility is most predictive? Ultrasound in Obstetrics & Gynecology. 2020;55(5):683-7.
Dietz HP, Stankiewicz M, Atan IK, Ferreira CW, Socha M. Vaginal laxity: what does this symptom mean? Int Urogynecol J. 2018;29(5):723-8.
Karcher C, Sadick N. Vaginal rejuvenation using energy-based devices. International Journal of Women's Dermatology. 2016;2(3):85-8.
Dobbeleir JMLCL, Landuyt KV, Monstrey SJ. Aesthetic surgery of the female genitalia. Semin Plast Surg. 2011;25(2):130-41.
Lee MS. Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90° and 360° Scanning Scopes: A Pilot Study & Short-term Results. Laser Ther. 2014;23(2):129-38.
Gaviria JE. Vaginal Tightening (LVT) - evaluation of a novel noninvasive laser treatment for vaginal relaxation syndrome. J LAHA. 2012;2012 no 1:59-66.
Newman R, Campbell PC, Gooneratne ML, Lowenstein L, Mu G, Qureshi AA, et al. Genito Pelvic Vaginal Laxity: Classification, Etiology, Symptomatology, and Treatment Considerations. Current Sexual Health Reports. 2018;10(4):222-36.
Davey L. Vaginal laxity and childbirth: is a "loose vagina" common? tratable? 2019 [cited 2020 10 August]. Available from: https://torontophysiotherapy.ca/vaginal-laxity-and-childbirth-is-a-loose-vagina-common/.
Farage MA, Maibach HI. Morphology and physiological changes of genital skin and mucosa. Curr Probl Dermatol. 2011;40:9-19.
Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH. Sexual activity and function in middle-aged and older women. Obstet Gynecol. 2006;107(4):755-64.
Campbell P, Krychman M, Gray T, Vickers H, Money-Taylor J, Li W, et al. Self-Reported Vaginal Laxity-Prevalence, Impact, and Associated Symptoms in Women Attending a Urogynecology Clinic. J Sex Med. 2018;15(11):1515-7.
Pauls RN, Fellner AN, Davila GW. Vaginal laxity: a poorly understood quality of life problem; a survey of physician members of the International Urogynecological Association (IUGA). Int Urogynecol J. 2012;23(10):1435-48.
Qureshi AA, Sharma K, Thornton M, Myckatyn TM, Tenenbaum MM. Vaginal Laxity, Sexual Distress, and Sexual Dysfunction: A Cross-Sectional Study in a Plastic Surgery Practice. Aesthet Surg J. 2018;38(8):873-80.
Tadir Y, Gaspar A, Lev-Sagie A, Alexiades M, Alinsod R, Bader A, et al. Light and energy based therapeutics for genitourinary syndrome of menopause: Consensus and controversies. Lasers Surg Med. 2017;49(2):137-59.
de Landsheere L, Brieu M, Blacher S, Munaut C, Nusgens B, Rubod C, et al. Elastin density: Link between histological and biomechanical properties of vaginal tissue in women with pelvic organ prolapse? Int Urogynecol J. 2016;27(4):629-35.
Wenstrup RJ, Florer JB, Brunskill EW, Bell SM, Chervoneva I, Birk DE. Type V collagen controls the initiation of collagen fibril assembly. J Biol Chem. 2004;279(51):53331-7.
Millheiser L, Kingsberg S, Pauls R. A CROSS-SECTIONAL SURVEY TO ASSESS THE PREVALENCE AND SYMPTOMS ASSOCIATED WITH LAXITY OF THE VAGINAL INTROITUS2010. 1102-3 p.
Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. Women's sexual health after childbirth. Bjog. 2000;107(2):186-95.
Dietz HP, Wilson PD, Milsom I. Maternal birth trauma: why should it matter to urogynaecologists? Curr Opin Obstet Gynecol. 2016;28(5):441-8.
Gachon B, Nordez A, Pierre F, Fritel X. Tissue biomechanical behavior should be considered in the risk assessment of perineal trauma at childbirth. Arch Gynecol Obstet. 2019;300(6):1821-6.
Abdool Z, Lindeque BG, Dietz HP. The impact of childbirth on pelvic floor morphology in primiparous Black South African women: a prospective longitudinal observational study. Int Urogynecol J. 2018;29(3):369-75.
Ruiz-Zapata AM, Heinz A, Kerkhof MH, van de Westerlo-van Rijt C, Schmelzer CEH, Stoop R, et al. Extracellular Matrix Stiffness and Composition Regulate the Myofibroblast Differentiation of Vaginal Fibroblasts. Int J Mol Sci. 2020;21(13):4762.
Capon A, Mordon S. Can thermal lasers promote skin wound healing? Am J Clin Dermatol. 2003;4(1):1-12.
Ibrahim O, Dover JS. Fundamentals of Laser and Light Based Treatments. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology. 1. 09 ed. new York: McGraw-Hill; 2019. p. 3820-33.
Manstein D, Joachim Laubach H. Fractional Photothermolysis. In: Nouri K, editor. Lasers in Dermatology and Medicine. London: Springer; 2011. p. 123-47.
Alexiades-Armenakas MR, Dover JS, Arndt KA. Fractional laser skin resurfacing. J Drugs Dermatol. 2012;11(11):1274-87.
Freedman JR, Greene RM, Green JB. Histologic effects of resurfacing lasers. Facial Plast Surg. 2014;30(1):40-8.
Gaspar A. Comparison of new minimally invasive Er: YAG laser treatment and hormonal replacement therapy in the treatment of vaginal atrophy. Climacteric. 2014;17:48-108.

[1] Manzini C, Friedman T, Turel F, Dietz HP. Vaginal laxity: which measure of levator ani distensibility is most predictive? Ultrasound in Obstetrics & Gynecology. 2020;55(5):683-7.

[2] Dietz HP, Stankiewicz M, Atan IK, Ferreira CW, Socha M. Vaginal laxity: what does this symptom mean? Int Urogynecol J. 2018;29(5):723-8.

[3] Karcher C, Sadick N. Vaginal rejuvenation using energy-based devices. International Journal of Women's Dermatology. 2016;2(3):85-8.

[4] Dobbeleir JMLCL, Landuyt KV, Monstrey SJ. Aesthetic surgery of the female genitalia. Semin Plast Surg. 2011;25(2):130-41.

[5] Lee MS. Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90° and 360° Scanning Scopes: A Pilot Study & Short-term Results. Laser Ther. 2014;23(2):129-38.

[6] Gaviria JE. Vaginal Tightening (LVT) - evaluation of a novel noninvasive laser treatment for vaginal relaxation syndrome. J LAHA. 2012;2012 no 1:59-66.

[7] Newman R, Campbell PC, Gooneratne ML, Lowenstein L, Mu G, Qureshi AA, et al. Genito Pelvic Vaginal Laxity: Classification, Etiology, Symptomatology, and Treatment Considerations. Current Sexual Health Reports. 2018;10(4):222-36.

[8] Davey L. Vaginal laxity and childbirth: is a "loose vagina" common? tratable? 2019 [cited 2020 10 August]. Available from: https://torontophysiotherapy.ca/vaginal-laxity-and-childbirth-is-a-loose-vagina-common/.

[9] Farage MA, Maibach HI. Morphology and physiological changes of genital skin and mucosa. Curr Probl Dermatol. 2011;40:9-19.

[10] Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH. Sexual activity and function in middle-aged and older women. Obstet Gynecol. 2006;107(4):755-64.

[11] Campbell P, Krychman M, Gray T, Vickers H, Money-Taylor J, Li W, et al. Self-Reported Vaginal Laxity-Prevalence, Impact, and Associated Symptoms in Women Attending a Urogynecology Clinic. J Sex Med. 2018;15(11):1515-7.

[12] Pauls RN, Fellner AN, Davila GW. Vaginal laxity: a poorly understood quality of life problem; a survey of physician members of the International Urogynecological Association (IUGA). Int Urogynecol J. 2012;23(10):1435-48.

[13] Qureshi AA, Sharma K, Thornton M, Myckatyn TM, Tenenbaum MM. Vaginal Laxity, Sexual Distress, and Sexual Dysfunction: A Cross-Sectional Study in a Plastic Surgery Practice. Aesthet Surg J. 2018;38(8):873-80.

[14] Tadir Y, Gaspar A, Lev-Sagie A, Alexiades M, Alinsod R, Bader A, et al. Light and energy based therapeutics for genitourinary syndrome of menopause: Consensus and controversies. Lasers Surg Med. 2017;49(2):137-59.

[15] de Landsheere L, Brieu M, Blacher S, Munaut C, Nusgens B, Rubod C, et al. Elastin density: Link between histological and biomechanical properties of vaginal tissue in women with pelvic organ prolapse? Int Urogynecol J. 2016;27(4):629-35.

[16] Wenstrup RJ, Florer JB, Brunskill EW, Bell SM, Chervoneva I, Birk DE. Type V collagen controls the initiation of collagen fibril assembly. J Biol Chem. 2004;279(51):53331-7.

[17] Millheiser L, Kingsberg S, Pauls R. A CROSS-SECTIONAL SURVEY TO ASSESS THE PREVALENCE AND SYMPTOMS ASSOCIATED WITH LAXITY OF THE VAGINAL INTROITUS2010. 1102-3 p.

[18] Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. Women's sexual health after childbirth. Bjog. 2000;107(2):186-95.

[19] Dietz HP, Wilson PD, Milsom I. Maternal birth trauma: why should it matter to urogynaecologists? Curr Opin Obstet Gynecol. 2016;28(5):441-8.

[20] Gachon B, Nordez A, Pierre F, Fritel X. Tissue biomechanical behavior should be considered in the risk assessment of perineal trauma at childbirth. Arch Gynecol Obstet. 2019;300(6):1821-6.

[21] Abdool Z, Lindeque BG, Dietz HP. The impact of childbirth on pelvic floor morphology in primiparous Black South African women: a prospective longitudinal observational study. Int Urogynecol J. 2018;29(3):369-75.

[22] Ruiz-Zapata AM, Heinz A, Kerkhof MH, van de Westerlo-van Rijt C, Schmelzer CEH, Stoop R, et al. Extracellular Matrix Stiffness and Composition Regulate the Myofibroblast Differentiation of Vaginal Fibroblasts. Int J Mol Sci. 2020;21(13):4762.

[23] Capon A, Mordon S. Can thermal lasers promote skin wound healing? Am J Clin Dermatol. 2003;4(1):1-12.

[24] Ibrahim O, Dover JS. Fundamentals of Laser and Light Based Treatments. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology. 1. 09 ed. new York: McGraw-Hill; 2019. p. 3820-33.

[25] Manstein D, Joachim Laubach H. Fractional Photothermolysis. In: Nouri K, editor. Lasers in Dermatology and Medicine. London: Springer; 2011. p. 123-47.

[26] Alexiades-Armenakas MR, Dover JS, Arndt KA. Fractional laser skin resurfacing. J Drugs Dermatol. 2012;11(11):1274-87.

[27] Freedman JR, Greene RM, Green JB. Histologic effects of resurfacing lasers. Facial Plast Surg. 2014;30(1):40-8.

[28] Gaspar A. Comparison of new minimally invasive Er: YAG laser treatment and hormonal replacement therapy in the treatment of vaginal atrophy. Climacteric. 2014;17:48-108.

Fractional erbium laser in vaginal laxity

Abstract

References

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