Non-Ablative Vaginal Erbium YAG Laser for the Treatment of Cystocele
Bizjak-Ogrinc U, Sencar S
Italian Journal of Gynaecology and Obstetrics (2017), 29(1):19-25, DOI:10.14660/2385-0868-59
Purpose: the aim of the study was to evaluate the effects of Vaginal Erbium Laser (VEL), a non-ablative solid state erbium-doped yttrium-aluminum-garnet crystal (Er:YAG) laser treatment for reduction of prolapses.
Methods: in this prospective cohort study, 61 patients with cystoceles of grades II–IV were submitted to 2-5 treatments with a nonablative VEL laser at 2-month intervals. At baseline and 2, 6 and 12-month followups, prolapses were photographed and graded using the Baden-Walker scale during a physical examination. Patients were interviewed at each follow-up about adverse effects and their satisfaction. Pain during treatment was measured on a 10-point visual analog scale (VAS).
Results: at baseline 40 patients presented with grade II cystoceles, 15 with grade III and 6 with grade IV cystoceles. At the final follow-up, the grade of prolapse was reduced by at least one grade in 95% of patients, with 85% of patients presenting with grade 0 or I prolapses and the remaining 15% of patients with grade II prolapses. Most patients were either very satisfied (57%) or satisfied (33%) with the treatment. Treatment discomfort was low (0.5 VAS). No major adverse effects were reported.
Conclusions: the results of this pilot study show that the non-ablative VEL treatment may improve cystoceles with minimal patient discomfort and no adverse effects. If these preliminary results will be confirmed in a properly designed, controlled study, then VEL could be considered in selected cases as a minimally-invasive alternative to surgery.