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Fractional CO2 laser for genitourinary syndrome of menopause in breast cancer survivors: clinical, immunological, and microbiological aspects

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Abstract

The composition of vaginal microbiome in menopause and cancer survivor women changes dramatically leading to genitourinary syndrome of menopause (GSM) in up to 70% of patients. Recent reports suggest that laser therapy may be valuable as a not hormonal therapeutic modality. The aim of the present study was to evaluate the effects of fractional CO2 laser treatment on the vaginal secretory pathway of a large panel of immune mediators, usually implicated in tissue remodeling and inflammation, and on microbiome composition in postmenopausal breast cancer survivors. The Ion Torrent PGM platform and the Luminex Bio-Plex platform were used for microbiome and immune factor analysis. The significant reduction of clinical symptoms and the non-significant changes in vaginal microbiome support the efficacy and safety of laser treatment. Moreover, the high remodeling status in vaginal epithelium is demonstrated by the significant changes in inflammatory and modulatory cytokine patterns. Laser therapy can be used for the treatment of GSM symptoms and does not show any adverse effects. However, further studies will be needed to clarify its long-term efficacy and other effects.

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Abbreviations

VVA:

Vulvovaginal atrophy

GSM:

Genitourinary syndrome of menopause

VRS:

Verbal Rating Scale

BV:

Bacterial vaginosis

VHI:

Vaginal Health Index

FSFI:

Female Sexual Function Index

FSDSr:

Female Sexual Distress Scale revised 2005

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Authorship

Conceptualization, M.C.; methodology, A.M.B., G.C., and N.Z.; software, G.C. and N.Z.; investigation, A.M.B., G.C., and N.Z.; resources, Z.T., S.G., F.P., A.P., and G.S.; data curation, G.C. and N.Z.; writing—original draft, G.C., N.Z., and M.C.; writing—review and editing, M.C.; visualization, G.C. and N.Z.; funding acquisition, M.C.

Funding

This study was supported by the Italian Ministry of Health, grant number RC 26/13.

Author information

Authors and Affiliations

  1. Section of Gynecology and Obstetrics, Department of Woman and Child Health, Careggi University Hospital, Largo Brambilla 3, 50144, Florence, Italy

    Angelamaria Becorpi, Zelinda Tredici, Secondo Guaschino, Felice Petraglia, Annalisa Pieralli & Giovanni Sisti

  2. Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, via dell’Istria 65/1, 34100, Trieste, Italy

    Giuseppina Campisciano, Nunzia Zanotta, Francesco De Seta & Manola Comar

  3. Department of Medical Sciences, University of Trieste, Piazzale Europa 1, 34127, Trieste, Italy

    Francesco De Seta & Manola Comar

Authors
  1. Angelamaria Becorpi
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  2. Giuseppina Campisciano
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  3. Nunzia Zanotta
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  4. Zelinda Tredici
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  5. Secondo Guaschino
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  6. Felice Petraglia
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  7. Annalisa Pieralli
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  8. Giovanni Sisti
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  9. Francesco De Seta
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  10. Manola Comar
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Corresponding author

Correspondence to Manola Comar.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Florence. The study was conducted in accordance with the Declaration of Helsinki.

Consent for publication

All patients who were recruited for the study signed an informed consent form.

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Becorpi, A., Campisciano, G., Zanotta, N. et al. Fractional CO2 laser for genitourinary syndrome of menopause in breast cancer survivors: clinical, immunological, and microbiological aspects. Lasers Med Sci 33, 1047–1054 (2018). https://doi.org/10.1007/s10103-018-2471-3

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  • DOI: https://doi.org/10.1007/s10103-018-2471-3

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