Application of CO2-fraction laser photothermolysis in gynecological practice

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Resumo

It is useful for clinicians to be aware of the risks, limitations, and outcomes of laser therapy. This article analyzes the development of laser fractional thermolysis in medicine and substantiates its use in gynecology. Definitions of key terms for working on laser devices are pressented. The stages of the use of fractional lasers in dermatology are described, the features of the physics of a laser on living tissues are explained, and the choice of the type of laser and the options for selecting its parameters are analyzed in detail, with the rationale for choosing the parameters of a CO2-laser for various gynecological diseases. The mechanism of induction of tissue regeneration during fractional photothermolysis due to the effects of photobiomodulation has been substantiated. The indications and contraindications for CO2-fraction laser thermolysis in aesthetic gynecology and urogynecology with examples from systematic reviews and meta-analyses are described, and ready-to-use protocols for working on a CO2-laser platform are presented. The examinations necessary before CO2-fraction laser thermolysis of the vagina and vulva are discussed.

Conclusion: Many professionals are concerned about the lack of published full and operational laser parameters to enable the clinician to use lasers for a safe and effective outcome. This article describes the basics of the interaction of a CO2-fraction laser with tissue and shows how different parameters of laser fractional thermolysis can be applied to various conditions in gynecology and urogynecology.

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Sobre autores

Elena Gorbunova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Autor responsável pela correspondência
Email: el_gorbunova@oparina4.ru
ORCID ID: 0000-0002-4723-4299

Obstetrician-gynecologist, Researcher, Department of Aesthetic Gynecology and Rehabilitation

Rússia, 117997, Moscow, Akademika Oparina str., 4

Inna Apolikhina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: i_apolikhina@oparina4.ru
ORCID ID: 0000-0002-4581-6295

MD, Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, Professor of the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Member of the Board of the Russian Society of Obstetricians and Gynecologists, President of the Association of Aesthetic Gynecology Specialists (AAGS)

Rússia, 117997, Moscow, Akademika Oparina str., 4; Moscow

Marina Ramazanova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: mar1naramazanova@yandex.ru
ORCID ID: 0000-0003-2508-7109

Obstetrician-gynecologist, Postgraduate, Department of Aesthetic Gynecology and Rehabilitation

Rússia, 117997, Moscow, Akademika Oparina str., 4

Bibliografia

  1. Salvatore S., Nappi R.E., Zerbinati N., Calligaro A., Ferrero S., Origoni M. et al. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric. 2014; 17(4): 363-9. https://dx.doi.org/10.3109/ 13697137.2014.899347.
  2. Дикке Г.Б., Гурская Т.Ю., Прокофьева С.В., Стольникова И.И., Андреева А.С., Репина Н.Б., Яговкина Н.В., Теплых С.В., Федорова Е.П. Эффективность и безопасность вагинального эстриола в ультранизкой дозе в терапии генитоуринарного менопаузального синдрома: многоцентровое рандомизированное контролируемое испытание III фазы. Акушерство и гинекология. 2022; 12: 146-56. [Dikke G.B., Gurskaya T.Yu., Prokofievа S.V., Stolnikova I.I., Andreeva A.S., Repina N.B., Yagovkina N.V., Teplykh S.V., Fedorova E.P. Efficacy and safety of ultra-low dose vaginal estriol in the therapy of genitourinary syndrome of menopause: a phase III multicenter randomized controlled trial. Obstetrics and Gynecology. 2022; (12): 146-56. (in Russian)]. https://dx.doi.org/10.18565/aig.2022.303.
  3. Salvatore S., Ruffolo A.F., Phillips C., Athanasiou S., Cardozo L., Serati M.; EUGA Working Group. Vaginal laser therapy for GSM/VVA: where we stand now - a review by the EUGA Working Group on Laser. Climacteric. 2023; 26(4): 336-52. https://dx.doi.org/10.1080/13697137.2023.2225766.
  4. Phillips C., Hillard T., Salvatore S., Toozs-Hobson P., Cardozo L. Lasers in gynaecology. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020; 251: 146-55. https://dx.doi.org/10.1016/j.ejogrb.2020.03.034.
  5. Perino A., Cucinella G., Gugliotta G., Saitta S., Polito S., Adile B. et al. Is vaginal fractional CO2 laser treatment effective in improving overactive bladder symptoms in post-menopausal patients? Preliminary results. Eur. Rev. Med. Pharmacol. Sci. 2016; 20(12): 2491-7.
  6. Fitzpatrick R.E., Rostan E.F., Marchell N. Collagen tightening induced by carbon dioxide laser versus erbium: YAG laser. Lasers Surg. Med. 2000; 27(5): 395-403. https://dx.doi.org/10.1002/1096-9101(2000)27:5<395:: AID-LSM1000>3.0.CO;2-4.
  7. Corazza M., Schettini N., Zedde P., Borghi A. Vulvar lichen sclerosus from pathophysiology to therapeutic approaches: evidence and prospects. Biomedicines. 2021; 9(8): 950. https://dx.doi.org/10.3390/biomedicines9080950.
  8. Аполихина И.А., Горбунова Е.А., Тетерина Т.А., Саидова А.С., Маковская Д.С., Казакова С.Н., Рамазанова М.О., Макарова Л.Н., Яроцкая Е.Л., Гагарина С.В., Иванова Е.А. Адаптированная и усовершенствованная терминология в эстетической гинекологии. Акушерство и гинекология. 2022; 11 (приложение). [Apolikhina I.A., Gorbunova E.A., Teterina T.A., Saidova A.S., Makovskaya D.S., Kazakova S.N., Ramazanova M.O., Makarova L.N., Yarotskaya E.L., Gagarina S.V., Ivanova E.A. Adapted and improved terminology in aesthetic gynecology. Obstetrics and Gynecology. 2022; (11, Suppl). (in Russian)].
  9. Parker S., Cronshaw M., Anagnostaki E., Mylona V., Lynch E., Grootveld M. Current concepts of Laser-Oral tissue interaction. Dent. J. (Basel). 2020; 8(3): 61. https://dx.doi.org/10.3390/dj8030061.
  10. Willey A., Anderson R.R., Azpiazu J.L., Bakus A.D., Barlow R.J., Dover J.S. et al. Complications of laser dermatologic surgery. Lasers Surg. Med. 2006; 38(1): 1-15. https://dx.doi.org/10.1002/lsm.20286.
  11. Parker S., Cronshaw M., Anagnostaki E., Bordin-Aykroyd S.R., Lynch E. Systematic review of delivery parameters used in dental photobiomodulation therapy. Photobiomodul. Photomed. Laser Surg. 2019; 37(12): 784-97. https://dx.doi.org/10.1089/photob.2019.4694.

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