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| Name | Class |
|---|---|
| Department of Obstetrics and Gynecology, Faculty of Medicine, CUNI, Pilsen, Czechia | UNKNOWN |
| NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czechia | UNKNOWN |
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Pelvic floor disorders, including prolapse, incontinence, and vulvovaginal atrophy decrease the quality of life of every fourth woman. Recent therapy including habits change, rehabilitation, surgery, or hormonal replacement is not possible in all patients. Laser therapy is currently being proposed as an alternative. Laser therapy was brought to the gynecological field from dermatology, where it is used for facial rejuvenation (wrinkles) and treatment of other skin abnormalities. In dermatology, the laser has proven its efficacy at the molecular and histological levels. However, this concept was brought to gynecology without comparable confirmation. The skin and vagina have a different structures, therefore effects of laser may differ. Patient satisfaction with the clinical effects of laser has been reported. However, based on recent reviews and sheep studies knowledge about histological and other effects is limited. The goal of this study is to gain knowledge about the histological, biomechanical effects and molecular effects of laser on vagina. Control samples were collected from women undergoing colporrhaphy. The laser group underwent laser treatment prior to the surgery. The gained knowledge may improve laser protocols and in the future maybe laser therapy will become standard treatment in urogynecology.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| laser | Experimental | laser treatment (Laser CO² MIXTO PRO, LASERING SRL, Modena, Italy; three sessions, one per month) |
|
| control | No Intervention | no intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| vaginal laser treatment | Other | non-ablative vaginal laser application |
|
| Measure | Description | Time Frame |
|---|---|---|
| uniaxial biomechanical analysis | Young's modulus of elasticity at low and high deformations | within month after completion of specimens |
| Measure | Description | Time Frame |
|---|---|---|
| quantitative histological analysis - epithelial thickness | Hematoxylin-eosin - epithelial thickness (um) | within 6 months after completion of specimens |
| quantitative immunohistochemistry -von Willebrand factor (vWF) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lucie Hajkova Hympanova, MD, PhD | Institute for the Care of Mother and Child, Prague, Czech Republic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute for the care of mother and child | Prague | 147 10 | Czechia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | P. Gupta, M. J. Ehlert, and J. M. Bartley, "Diagnosis and Management of Complex Pelvic Floor Disorders in Women," vol. 22, no. 6, pp. 275-285, 2015. | ||
| 28763401 | Background | Cruz VL, Steiner ML, Pompei LM, Strufaldi R, Fonseca FLA, Santiago LHS, Wajsfeld T, Fernandes CE. Randomized, double-blind, placebo-controlled clinical trial for evaluating the efficacy of fractional CO2 laser compared with topical estriol in the treatment of vaginal atrophy in postmenopausal women. Menopause. 2018 Jan;25(1):21-28. doi: 10.1097/GME.0000000000000955. | |
| 12786881 |
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| ID | Term |
|---|---|
| D059952 | Pelvic Floor Disorders |
| ID | Term |
|---|---|
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D011248 | Pregnancy Complications |
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microvessels density (mm-2) The number of von Willebrand factor-positive microvessel profiles was divided by the sum of the areas of the counting frame and expressed as a two-dimensional density of microvessels (QA, quantity per area)
| within 6 months after completion of specimens |
| quantitative immunohistochemistry -orcein | elastin fibres - Area fraction ( %) | within 6 months after completion of specimens |
| quantitative immunohistochemistry- picrosirius red | collagen I and III - Area fraction ( %) | within 6 months after completion of specimens |
| molecular analysis - markers of inflammation | PCR (polymerase chain reaction) - TGFB (Transforming growth factor beta) | within 6 months after results of histological analysis |
| molecular analysis - markers of inflammation | PCR - IL- 1 (Interleukin-1) | within 6 months after results of histological analysis |
| molecular analysis - connective tissue remodeling | PCR - COLL1 (collagen type I) | within 6 months after results of histological analysis |
| molecular analysis - connective tissue remodeling | PCR - MMP 1 (Matrix Metallopeptidase 1) | within 6 months after results of histological analysis |
| Background |
| Papadavid E, Katsambas A. Lasers for facial rejuvenation: a review. Int J Dermatol. 2003 Jun;42(6):480-7. doi: 10.1046/j.1365-4362.2003.01784.x. |
| 25417568 | Background | Kauvar AN. Fractional nonablative laser resurfacing: is there a skin tightening effect? Dermatol Surg. 2014 Dec;40 Suppl 12:S157-63. doi: 10.1097/DSS.0000000000000200. |
| 20855774 | Background | Reilly MJ, Cohen M, Hokugo A, Keller GS. Molecular effects of fractional carbon dioxide laser resurfacing on photodamaged human skin. Arch Facial Plast Surg. 2010 Sep-Oct;12(5):321-5. doi: 10.1001/archfacial.2010.38. |
| 29033365 | Background | Conte C, Jauffret T, Vieillefosse S, Hermieu JF, Deffieux X. Laser procedure for female urinary stress incontinence: A review of the literature. Prog Urol. 2017 Dec;27(17):1076-1083. doi: 10.1016/j.purol.2017.09.003. Epub 2017 Oct 21. |
| 28778337 | Background | Pitsouni E, Grigoriadis T, Falagas ME, Salvatore S, Athanasiou S. Laser therapy for the genitourinary syndrome of menopause. A systematic review and meta-analysis. Maturitas. 2017 Sep;103:78-88. doi: 10.1016/j.maturitas.2017.06.029. Epub 2017 Jun 27. |
| 33235032 | Background | Hympanova L, Rynkevic R, Mori Da Cunha MGMC, Diedrich CM, Blacher S, De Landsheere L, Mackova K, Krofta L, Roovers JP, Deprest J. The ewe as an animal model of vaginal atrophy and vaginal Er:YAG laser application. Menopause. 2020 Nov 23;28(2):198-206. doi: 10.1097/GME.0000000000001679. |
| 18799443 | Result | Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ; Pelvic Floor Disorders Network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008 Sep 17;300(11):1311-6. doi: 10.1001/jama.300.11.1311. |
| D052801 | Male Urogenital Diseases |