Long-term efficacy of CO2 fractional laser in the treatment of genitourinary syndrome of menopause.

The aim of this study was to evaluate the long-term efficacy and adverse effects of fractionated CO2 laser in the treatment of GSM (Genitourinary Syndrome of menopause). This was a retrospective, monocentric, study conducted between January 2017 and July 2023. Forty-six patients receiving 3 sessions of fractional CO2 laser at 4-6 weeks apart were included. The primary endpoint was the satisfaction of the patient (unsatisfied, neutral or satisfied) 24 months after the treatment. Secondary endpoints were improvement of their GSM, with the use of a sexual health and quality of life scores (FSFI and SF-12), changes in the use of local treatments and adverse events. A sub-group analysis evaluated patients with a history of breast cancer and patient ongoing antihormone therapy. Twenty-four months after treatment, 41 % (n = 19) patients were satisfied, 21 % (n = 10) patients were neutral, and 38 % (n = 17) patients were unsatisfied. There was a significant reduction in hypoesthesia during intercourse (p = 0.007), vaginal discharge (p = 0.009) and vaginal dryness (p = 0.0003). There was no significant improvement in SF-12, FSFI scores or reduction in the use of local treatments. No serious short- or long-term adverse events were reported. Among patients with a history of breast cancer (n = 26), there was a significant reduction in hypoesthesia during intercourse (p = 0016), vaginal discharge (p = 0.041) and vaginal dryness (p = 0.0004). The CO2 fractional laser showed an improvement in GSM 24 months after treatment. In the population of patients followed for breast cancer, results were also promising over the long term of treatment.