Resumen

Objectives: Genitourinary syndrome of menopause (GSM) has great negative effects on patients’ urogenital health, sexual function, body image, self-esteem and even quality of life. Until 2002, first choice of GSM treatment were hormones, But Due to the several side effects and contraindications of this treatment, laser with hyaluronic acid local injection with less side effects and noticeable therapeutic advantages have gained more attention in recent years. Introduction: Nevertheless, there are no enough scientific evidences for evaluate and comparing therapeutic results of laser alone with laser combined with hyaluronic acid injection as chromophore. So we aimed to compare the Co2 laser alone and combined with topical hyaluronic acid injection for GSM treatment. Materials / method: in this randomized clinical trial 80 sexuality active postmenopausal women were selected and randomly divided into laser group (n=40) and laser with hyaluronic acid group (n=40). group one was treated in 3 sessions laser with power of 35-40 W, dwell time of 800-1,000 seconds, dot spacing of 800-1,000 µm and single or double stack. For the second group, in addition to laser treatment with the same protocol as group one, 1 cc of submucosal hyaluronic acid was also injected as laser chromophore. Severity of GSM syndrome symptoms were scored by a Likert questionnaire in 20, 40 and 60 day intervals Results: Analyzed data showed no meaningful differences in mean age, education and marital status between two groups. there was no meaningful difference in GSM symptoms mean scores between two groups before the intervention. meaningful statistical deference in GSM signs mean scores was seen just in 60 days follow up and laser and HA injection group showed better treatment results in 60 days after the intervention compared with the only laser group. There was no meaningful difference in GSM signs mean scores in 20 and 40 days of follow up between two groups. Conclusion: It can be concluded that CO2 laser in combination with HA topical injection gives better therapeutic advantages in 2 months follow up and can shorten the treatment length in GSM treatment. Using HA gel injection and laser for GSM treatment, speeds up recovery and patients achieve desirable quality of life and self-esteem in a shorter time.