Objective: Use of laser therapy has most recently been introduced as a non-invasive option for the treatment of genitourinary syndrome of menopause (GSM). Recent literature has shown promise in providing benefit for patients with symptoms of vulvovaginal atrophy (VVA) and stress urinary incontinence with minimal adverse effects. Despite this, the United States Food and Drug Administration has not cleared laser therapy for these specific indications given the lack of sufficient evidence to support safety and efficacy.
A case is presented of a patient with GSM in the setting of lichen sclerosus who was referred to a tertiary vulvovaginal disease clinic after worsening of symptoms after three laser therapy treatments. Patient data is protected by the Health Insurance Portability and Accountability Act of 1996.
The case presented demonstrates initial worsening of symptoms after treatment with laser therapy, with initial exam findings showing atrophic vaginitis, marked introital narrowing, partial phimosis of the clitoral hood, and fusion of the labia minor and majora. The patient ultimately had complete resolution of post-laser therapy symptoms by one year after initial presentation. The case findings and follow-up are presented.
Conclusions: Despite case series and studies in the literature showing promise of the use of laser therapy for GSM and urinary incontinence, laser therapy is not currently FDA-approved for these indications. Large scale, long-term prospective randomized controlled data is necessary to provide data on the safety, efficacy, indications, and appropriate candidates for laser therapy.
Laser therapy, lichen sclerosus, atrophic vaginitis, vulvovaginal atrophy, genitourinary syndrome of menopause
The authors report no conflict of interest.
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Bakir S, Winn H, Elas D, Stockdale CK. Effects after use of laser therapy for vulvovaginal atrophy in a patient with lichen sclerosus: a case report. Proc Obstet Gynecol. 2020 Nov 10;10(1):Article 12 [9 p.]. . Free full text article.