CO 2 laser, radiofrequency, and promestriene in the treatment of genitourinary syndrome of menopause in breast cancer survivors: a histomorphometric evaluation of the vulvar vestibule.

Autor:	Fernandes MFR; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Bianchi-Ferraro AMHM; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Sartori MGF; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Jármy Di Bella ZIK; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Cantarelli GC; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Dedonatto C; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Vanzin RB; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Dardes RCM; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Logullo ÂF; Department of Pathology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Patriarca MT; From the Department of Gynecology, Federal University of São Paulo-Paulista Medical School, Escola Paulista de Medicina (EPM) of Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Menopause (New York, N.Y.) [Menopause] 2023 Dec 01; Vol. 30 (12), pp. 1213-1220. Date of Electronic Publication: 2023 Nov 14.
DOI:	10.1097/GME.0000000000002274
Abstrakt:	Objective: This study aimed to compare the efficacy of CO 2 laser, radiofrequency, and promestriene in treating genitourinary syndrome of menopause in women with breast cancer receiving adjuvant therapy and to analyze the clinical and histological findings of the vulvar vestibule. Methods: Women with moderate-to-severe symptoms of vulvar atrophy were enrolled. The participants were evaluated according to pretreatment and posttreatment protocols using the visual analog scale and clinical assessments, which included a gynecological examination and vestibular biopsy. Participants were randomly assigned into the laser, radiofrequency, or promestriene groups. Participants in the energy treatment groups underwent three consecutive monthly outpatient vulvovaginal treatment sessions, whereas those in the control group were administered promestriene for 4 months. During a follow-up visit 30 days posttreatment, the participant global posttreatment impression of improvement was evaluated using a Likert scale. Results: Seventy women completed treatment. Histological vulvar atrophy was identified in four (5.7%) of the pretreatment vulvar samples. Postintervention, all histological parameters were normalized. Significant improvements in symptoms were observed, as all three groups showed a reduction in the visual analog scale score, with no statistically significant differences among them. A high level of satisfaction was reported posttreatment in all groups. No damage to the histological structure of the vulvar vestibule or relevant clinical adverse events were identified posttreatment. Conclusions: Laser, radiofrequency, and promestriene delivered comparable, significant symptom improvements among women with breast cancer receiving adjuvant therapy. These treatments did not cause structural tissue damage or other clinical complications. Competing Interests: Financial disclosures/conflicts of interest: None reported. (Copyright © 2023 by The Menopause Society.)
Databáze:	MEDLINE
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