Vaginal Laser Therapy as a Potential Treatment Option for Postmenopausal Women With Recurrent Cystitis: Initial Experience From a Single Institution
Abe, H., Urabe, F., Nakazono, M., Kawaharada, A. & Kimura, T.,
2025. Lasers in surgery and medicine
Abstract
Background: Recurrent cystitis is a prevalent condition, especially among postmenopausal women, significantly impairing their quality of life. Antibiotic therapy has historically been the primary treatment; however, concerns over antimicrobial resistance have highlighted the need for alternative therapies. Vaginal laser therapy, a noninvasive approach, has shown promise in improving vaginal health and may help prevent recurrent cystitis. This study assessed the efficacy of vaginal laser therapy in reducing cystitis episodes and improving the vaginal environment among postmenopausal women with recurrent cystitis.
Methods: This retrospective study involved 51 postmenopausal women who received vaginal laser therapy between January 2023 and July 2024. Eligible patients underwent a pretreatment phase with estriol ovules, followed by vaginal laser therapy. The Vaginal Health Index (VHI), vaginal pH, and cystoscopic findings were evaluated before and after treatment and are presented as median (interquartile range). The cystitis-free interval (CFI) was calculated to assess the duration between treatment and recurrence.
Results: The median number of cystitis episodes significantly decreased from 4 (3-6) in the 6 months before treatment to 0 (0-1) in the 6 months after treatment (p < 0.001 unless stated otherwise). The median CFI was 9.2 months. The VHI score significantly improved from 10 (9-13) to 18 (15-21), and vaginal pH significantly decreased from 8.0 to 5.5. Cystoscopic assessments indicated significant improvements in the atrophy of vaginal and periurethral tissues. Only grade 1 adverse events (7.8%) were observed, including vaginal pain and dyspareunia.
Conclusions: Vaginal laser therapy significantly reduced cystitis episodes and improved vaginal tissue health in postmenopausal women with recurrent cystitis. These findings suggest that this therapy may represent a promising alternative in selected patients. Further studies with larger sample sizes and prospective designs are required to confirm these results and investigate the long-term benefits of vaginal laser therapy in managing recurrent cystitis.
Keywords: postmenopausal women; recurrent cystitis; vaginal health index; vaginal laser therapy; vaginal pH.