Highlights
- •Intravaginal laser therapy appears promising for the treatment of genitourinary syndrome of menopause.
- •Available studies consistently indicate alleviation of all symptoms of genitourinary syndrome of menopause.
- •Sexual function and quality of life may improve to a clinically meaningful degree.
- •Local pathophysiology may regain premenopausal status.
- •Quality of evidence is “low” or “very low” and randomised controlled trials are not available.
Abstract
This study aimed to identify and then synthesize all available data regarding the
efficacy of laser therapy for postmenopausal women with genitourinary syndrome of
menopause (GSM) with/without urinary incontinence (UI). PubMed, Scopus, Web of Science,
Cochrane Library and ClinicalTrials.gov were searched in October 2016. The keywords
were “laser genitourinary syndrome of menopause”, “laser vulvovaginal atrophy”, “laser
vaginal atrophy” and “laser women incontinence”. Quality of reporting and risk of
bias of the included studies were assessed according to STROBE and MINORs checklists,
respectively. Quality of the body of evidence was evaluated with the GRADE approach.
Fourteen studies involving 542 participants were included in this systematic review
and meta-analysis. All GSM symptoms (dryness/dyspareunia/itching/burning/dysuria/urgency/frequency)
and UI decreased significantly and consistently in all available publications. The
pooled mean differences for the various symptoms were: dryness −5.5(95%CI:−6.7,−4.4;7studies;I2:0%), dyspareunia −5.6(95%CI:−6.8,−4.5;7 studies;I2:0%), itching −4(95%CI:−5.7,−2.2;6 studies;I2:79%), burning −3.9(95%CI:−5.9,−2;6 studies;I2:87%), dysuria −2.9(95%CI:−5.1,−0.7;4 studies;I2:90%) and UI −4.9(95%CI:−6.4,−3.4;2 studies;I2:0%). Because urgency/frequency was assessed by different methodologies the data could
not be meta-analyzed. Furthermore, KHQ, UDI-6, MCS12/PCS12, FSFI, overall sexual satisfaction
and measurements of the effect of laser therapy on the local pathophysiology improved
significantly. In conclusion, laser therapy for postmenopausal women with GSM appears
promising. It may reduce symptom severity, improve quality of life of postmenopausal
women and restore the vaginal mucosa to premenopausal status. However, the quality
of the body of evidence is “low” or “very low” and, thus, evidence-based modification
of current clinical practice cannot be suggested.
Keywords
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Article info
Publication history
Published online: June 27, 2017
Accepted:
June 22,
2017
Received in revised form:
June 18,
2017
Received:
February 13,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
