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The efficacy of CO2 laser in the treatment of genitourinary syndrome of menopause: a systematic review and meta-analysis of randomized controlled trials

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Abstract

CO2 laser has been proposed as a treatment strategy for genitourinary syndrome of menopause (GSM). In order to assess its efficacy for treating GSM, we conducted a systematic review and meta-analysis. To identify the current state of randomized controlled trials on CO2 laser therapy for GSM, a literature review was conducted. We systematically searched the following databases: PUBMED, EMBASE and the Cochrane Controlled Trials Register. In addition, a review of the references in the retrieved studies was carried out. Of 562 identified studies, 9 were eligible and were included in our analysis, involving 523 patients in total. Based on our analysis, CO2 laser has no statistical difference compared with estrogen in VHI (p = 0.87), FSFI total score (p = 0.19), FSFI-Arousal (p = 0.11), FSFI-Desire (p = 0.72), FSFI-Orgasm (p = 0.45) and FSFI-Satisfaction (p = 0.08). The meta-analysis also showed that CO2 laser significantly improved FSFI-Lubrication scores compared with estrogen therapy (p = 0.0004). Furthermore, compared with the sham group, CO2 laser group had statistically improved VHI scores (p = 0.003) and FSFI scores (p < 0.00001). CO2 laser therapy may be an effective alternative to estrogen therapy for GSM both in cases where estrogen is not applicable because of comorbidities and in cases in which women do not desire to take estrogen.

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Funding

This work was supported by grants from the National Nature Science Foundation of China (Nos. 81870525), Taishan Scholars Program of Shandong Province (No.tsqn201909199).

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Author notes

  1. Qiancheng Mao, Tong Cai and Haijuan Li contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China

    Qiancheng Mao, Yuanshan Cui & Jitao Wu

  2. The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China

    Tong Cai

  3. Department of Clinical Nutrition, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China

    Haijuan Li

  4. Department of Scientific Research, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China

    Yongli Chu

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  1. Qiancheng Mao
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Contributions

Conceptualization: Yuanshan Cui. Data curation: Qiancheng Mao, Tong Cai. Formal analysis: Qiancheng Mao, Tong Cai. Funding acquisition: Jitao Wu, Yuanshan Cui. Investigation: Qiancheng Mao, Tong Cai. Methodology: Qiancheng Mao, Tong Cai. Project administration: Yushan Cui. Resources: Qiancheng Mao, Tong Cai. Software: Qiancheng Mao, Tong Cai. Supervision: Yuanshan Cui, Jitao Wu. Writin10g – original draft: Qiancheng Mao, Tong Cai. Writing – review & editing: Yuanshan Cui.

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Correspondence to Yuanshan Cui or Jitao Wu.

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Mao, Q., Cai, T., Li, H. et al. The efficacy of CO2 laser in the treatment of genitourinary syndrome of menopause: a systematic review and meta-analysis of randomized controlled trials. Lasers Med Sci 38, 152 (2023). https://doi.org/10.1007/s10103-023-03808-z

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