Objectives: To find a cytological parameter that allows us to proactively indicate a laser-induced treatment, and to correlate it with post-treatment histological changes in women with severe asymptomatic vaginal atrophy, to avoid future unpleasant symptomatic episodes for the patient.
Introduction: The need for effective treatment of vaginal atrophy requires a consideration of the effectiveness of the laser-induced treatment, which is based on mild and controlled heating of the vaginal tissue, which stimulates angiogenesis, fibroblast activity and new collagen formation without thermal or ablative damage. The final result is increased epithelial thickness as well as vascularization of the lamina propria, along with a reduction of symptoms such as dryness, itching, irritation and dyspareunia.
Materials / method: 40 postmenopausal patients with severe, asymptomatic vaginal atrophy enrolled. Previous cytological evaluation confirming maturation index of the epithelium less than 25 done, compatible with atrophy, in all women studied. Biopsies were performed on a smaller group, followed by the protocol of a single session of Renovalase to determine if rate of maturation value could improve, remove vulnerability of suffering symptoms and correlate changes with histological findings. 33 of the 40 patients followed-up for a year, with cytological evaluation, and biopsies in some, at 1, 3, 6, and 12 months.
Results: A significant improvement in the epithelial maturation value index was observed in one hundred percent of the treated patients, going from less than 25 to more than 50, and in many of them even more than 65, which means proper trophism. These changes were also correlated with the histological improvement expressed in increment of the epithelial thickness, the glycogenic load and the amount of vascularization in the lamina propria. These outcomes were maintained during the twelve months of follow-up.
Conclusion: Our results show that carrying out a single session of this laser-induced treatment to asymptomatic postmenopausal patients reduces the risk of suffering the possibility of future symptoms of the so-called Genitourinary Syndrome of Menopause.
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