Vaginal Fractional CO2 Laser: A Minimally Invasive Option for Vaginal Rejuvenation

Abstract

Introduction: To provide evidence that the use of a fractional CO2 laser in combination with platelet-rich plasma (PRP) locally in the vagina mucous with minimal to moderate atrophy and pelvic floor exercise with perineometer would have effects of greater impact in the 3 layers of vaginal walls, including an important decrease of discomfort during sex. Materials and Methods: The study was composed of 2 groups: a study group and a control group. The main consultation purposes were vaginal dryness, dyspareunia, and local irritation. The study group underwent PRP, CO2 laser, and pelvic exercise, whereas only PRP and pelvic exercise were applied to the control group. We used a special vaginal scanner, which was able to fractionize the laser and could be inserted in the vagina. Both groups were evaluated with a sexual questionnaire and vaginal biopsies. Results: An important improvement of vaginal mucous histology and a decrease of discomfort during sex were observed in most patients in the study group compared with the control group. Conclusion: Through the local use of vaginal fractional CO2 laser, PRP, and pelvic floor exercises in women with symptoms of vaginal atrophy, beneficial effects are exerted in the 3 layers of the vagina rather than only the epithelium, as achieved with estrogens. We also observed a significant decrease of discomfort during sex. More data will be needed to better address the use of this new procedure.