Ultrasonic Evaluation of Carbon Dioxide Laser Effects on Patients With Genitourinary Syndrome

The aim of the study was to evaluate the efficacy of vaginal Carbon Dioxide Laser treatment in patients with Genitourinary Syndrome of Menopause on the improvement of Vulvovaginal Atrophy (VVA) and stress urinary incontinence (SUI) by objective parameters and in particular to assess the ultrasound measurement of specific vaginal parameters in order to evaluate a new objective tool of assessment.

Study Overview

• Status: Completed
• Conditions: Genitourinary Syndrome of Menopause

• Study Type: Observational
• Enrollment (Actual): 31

Contacts and Locations

Study Locations

• Italy
  • Lazio
    • Roma, Lazio, Italy, 00168
      • FPG gemelli RCCS

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Menopausal patients that attended our clinic of menopausal disorders and performed Carbon Dioxide Laser therapy for genitourinary syndrome.

In order to enroll patients with Genitourinary Syndrome of Menopause, the investigator used the Vaginal Health Index (VHI), Vulvar Health Index (VuHI), and Stress Urinary Incontinence (SUI) scales.

• The VHI score assesses vaginal health, with a cutoff of <15 on the index to diagnose patients with atrophy [ranging from "complete atrophy" (0) to "optimal vaginal health" (25)].
• The VuHI score assesses vulvar health, on a scale from normal (0) to severe (3). The overall score ranges from 0 to 24, and its cutoff for diagnosing atrophic vulva is >8 on the index.
• Stress Urinary Incontinence (SUI) is characterized by sudden urine loss. Evaluated using the Stamey score, with ratings of no incontinence (0) to severe incontinence (3).

Description

Inclusion Criteria:

• Age <75 years, menopause (naturally, pharmacologically or surgically induced, at least 12 months)
• Negative Papanicolaou test (PAP) performed within 12 months before enrolment. and one of the following:
• Presence of vulvovaginal atrophy [vaginal health index (VHI) < 15]
• Initial Urinary Incontinence based on patient history = 1 (according to the "Stamey incontinence score of Stress Urinary Incontinence" - min. 0 = no incontinence, max. 3 = severe incontinence)
• Standardized stress provocation test

Exclusion Criteria:

• Age >45 years
• The presence of vaginal lesions (active or in the previous 30 days).
• genitourinary tract infection.
• abnormal uterine bleeding.
• use of hormone replacement therapy up to 6 months before enrolment.
• history of photosensitivity disorder or use of photosensitizing drugs.
• genitals prolapse (grade II - III according to the Pelvic Organ Prolapse Quantification)
• a serious or chronic condition that could interfere with study compliance.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluating the effectiveness of Carbon Dioxide Laser in patients with genitourinary syndrome of menopause in terms of the improvement in a specific vaginal ultrasonographic parameters	To evaluate the primary outcome, we examined the following vaginal ultrasonographic parameters (by transvaginal probe), both before and after 3 vaginal Carbon Dioxide Laser applications: Thickness of the anterior vaginal walls (VWT) at the level of the introitus of the inferior vaginal third (expressed in millimeters);; Thickness of the posterior VWT at the level of the introitus of the inferior vaginal third (expressed in millimeters). Positive outcomes are evidenced if thickness (expressed in millimeters) is increased after treatment in both anterior and posterior vaginal walls.	4 months

Collaborators and Investigators

• Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Study record dates

Study Major Dates

• Study Start (Actual): January 11, 2021
• Primary Completion (Actual): December 12, 2021
• Study Completion (Actual): January 9, 2022

Study Registration Dates

• First Submitted: July 18, 2023
• First Submitted That Met QC Criteria: November 20, 2023
• First Posted (Estimated): November 21, 2023

Study Record Updates

• Last Update Posted (Estimated): November 21, 2023
• Last Update Submitted That Met QC Criteria: November 20, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease; Syndrome
• Other Study ID Numbers: 4689

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No