Efficacy and safety of carbon dioxide laser therapy compared with sham for genitourinary syndrome of menopause management: a meta-analysis of randomized clinical trials

Author:

Gunawan Yuliana W.1ORCID,Erlina Yunita2

Affiliation:

1. Soedjono Military Hospital, Magelang, Central Java, Indonesia

2. Department of Obstetrics and Gynecology, Bhumi Mother and Child Clinic, Magelang, Central Java, Indonesia.

Abstract

Abstract Importance Data on whether the carbon dioxide (CO2) laser is useful for treatment of genitourinary syndrome of menopause (GSM) are inconsistent. Objective This meta-analysis evaluated the benefits and safety of CO2 laser compared with sham treatment of GSM. Evidence Review A relevant literature search of Europe PMC, MEDLINE, Scopus, and ClinicalTrials.gov databases using specific keywords was conducted. The results of continuous variables were pooled into the standardized mean difference (SMD), whereas dichotomous variables were pooled into odds ratio with 95% confidence intervals (95% CI) using random-effects models. A funnel plot was used to assess for the presence of publication bias. Findings A total of six randomized clinical trials were included. Pooled analysis revealed that CO2 laser therapy was associated with a higher reduction in the Vaginal Assessment Scale (SMD, −0.81 [95% CI, −1.59 to −0.04]; P = 0.04; I 2 = 88%) and Urinary Distress Inventory short form (SMD, −0.45 [95% CI, −0.84 to −0.06]; P = 0.02; I 2 = 0%), and greater patient satisfaction rate (odds ratio, 5.46 [95% CI, 2.23 to 13.37]; P = 0.0002; I 2 = 0%) when compared with sham-only treatment. Meanwhile, the Female Sexual Function Index, Vaginal Health Index, and Patient Global Impression Improvement did not differ significantly between groups. Adverse events were only mild with no serious adverse events reported. Conclusions and Relevance CO2 laser therapy may improve the overall treatment of GSM with a relatively good safety profile. However, further randomized clinical trials with larger sample sizes are still needed to confirm the results of this study.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Obstetrics and Gynecology,General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Letter to the Editor;Menopause;2024-07

2. Lasers in Gynecology;Obstetrics & Gynecology;2024-06-06

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