Correction of urodynamic disorders in women with genitourinary syndrome using a fractional CO2-laser

Abstract

This article is devoted to the treatment of urodynamic disorders in women with the genitourinary syndrome by using a fractional CO2-laser. Nowdays, the development of genitourinary syndrome is an urgent problem among women of different ages. Genitourinary disorders are a complex of symptoms associated with the development of atrophic and dystrophic processes in the estrogenic tissues (the urethra, lower third of the uterus, pelvic floor ligaments and muscles). The objective: to determine the pathogenetic effectiveness of CO2 laser in the treatment of urodynamic disorders in premenopausal women with genitourinary syndrome.Materials and methods. The study covered 130 female patients with symptoms of the genitourinary syndrome. The patients were divided into two groups depending on their treatment. The main group consisted of 56 women using CO2 laser therapy. The comparison group consisted of 74 women who were treated with local application of hormone. To assess the efficacy of treatment and the functional status of the lower urinary tract, a comprehensive pre-treatment and post-treatment urodynamic examination were performed.Results. The average age of the patients in the examined groups was 47.2±2.5 years. After the treatment, the urodynamic examination showed an increase of the maximal intraurethral pressure from 16.8±17.9 to 26.7±21.2 mm Hg in the main group (p<0.01). The urethral closure pressure increased from 15.3±13.2 to 26.8±18.5 mm Hg (p<0.01). These changes were found upon examination of the functional length of the urethra, which increased from 2.0±0.3 to 3.0±0.4 cm, and thus reached normative values for healthy women. At the same time, the pre-treatment and post-treatment indicators did not statistically differ in comparison group.Conclusions. The results of the study show that the MonaLisaTouch method of laser fractional ablation of vaginal and vulva epithelium is highly effective compared with local hormonal therapy and can be recommended as a monotherapy for urogenital disorders and pelvic floor dysfunction.