Efectos del láser mixto de longitudes de onda 10600 NM (CO2) + (ER:GLASS) en el síndrome genitourinario de la menopausia

Identificador:  TDX:4544

Handle: https://hdl.handle.net/20.500.11797/TDX4544

Autores:  Salinas Peña, juan

Resumen:
Introduction: Genitourinary syndrome of menopause (GSM) is a chronic and progressive condition. With increasing life expectancy, women are spending more time in menopause, which, combined with the adverse effects or contraindications of hormonal therapy, has led to a growing interest in energy-based devices (EBD) as a treatment option. Vaginal laser therapy is the most extensively studied and published technology. The non-ablative 1540 nm wavelength in this mixed laser delivers a deeper hyperthermic effect in the vaginal mucosa compared to the CO2 laser. This enhanced effect could potentially reverse atrophic changes and allow for a reduction in the power and aggressiveness of CO2 laser ablation. We employed a wavelength combination of “10600 nm” and “1540 nm” to evaluate its efficacy and safety using low-power 5 W CO2 on vaginal maturation value (VMV) and symptoms of the GSM. Material and Methods: A randomized single-blind sham-controlled trial was conducted involving 31 postmenopausal women with GSM symptoms refractory to standard treatments. Participants received either laser or sham intervention monthly for three months. Primary and secondary outcomes included vaginal maturation value (VMV), vaginal pH, and visual analog scale (VAS) scores for GSM symptoms at 3 and 9 months post-intervention, along with adverse event assessments. Results: 27 patients completed the study, the laser group showed significant VMV improvement at three months (44.5% ± 4.4) compared to the sham group (27.7% ± 6.3) (P = 0.033). At nine months, VMV returned to baseline in the laser group, with significant dyspareunia VAS score reductions (P = 0.049). Vaginal pH remained unchanged, and adverse effects were similar to placebo. Conclusions: The combined CO2 “10600 nm” and Er:Glass “1540 nm” laser treatment effectively increased VMV and reduced dyspareunia with fewer side effects and faster recovery times than CO2 alone. The treatment was safe, well-tolerated, and yielded high patient satisfaction.