Efficacy of CO2 laser treatment in postmenopausal women with vulvovaginal atrophy: a meta-analysis.

OBJECTIVE Vulvovaginal atrophy (VVA) is a disorder that occurs in postmenopausal women. This study was to explore the efficacy of CO2 laser treatment in postmenopausal VVA women. METHOD PubMed, Embase, Cochrane Library and Web of Science were searched to June 9th, 2020. Prospective studies on the efficacy of CO2 laser treatment were included. Two researchers independently reviewed articles and extracted data. Heterogeneity test was conducted for each outcome indicator. Sensitivity analysis was performed in all models. RESULTS Twelve literatures including 459 participants were enrolled. Compared to baseline, VHIs were significantly higher at 1-, 3-, 6-, and 12-month follow-ups (P<0.001). For VVA severity, VAS scores in vaginal dryness at 1-, 3-, 6-, and 12-month follow-ups (P<0.050), in vaginal burning, itching and dysuria at 1-month follow-up (P<0.001), and in dyspareunia at 1-, 3-, 6-, and 12-month follow-ups (P<0.001) were all significantly lower. For FSFI, total scores at 1-, 3-, 6-, and 12-month follow-ups (P<0.001), and the scores in desire, arousal, lubrication, orgasm, satisfaction, and pain at 1-month follow-up (P<0.050) were all significantly higher. For QoL, PCS12 and MCS12 scores were all significantly higher (P<0.050) at 1-month follow-up. CONCLUSION CO2 laser treatment may be effective for post-menopausal women with VVA symptoms in improving QoL and sexual function.