The Effect of Fractional CO2 Laser Treatment on the Symptoms of Pelvic Floor Dysfunctions: Pelvic Floor Distress Inventory-20 Questionnaire

Background and Objectives To assess the improvement on pelvic floor distress (PFD)-related urogenital symptoms using validated questionnaires after intravaginal CO2 laser treatment. Study Design/Materials and Methods Forty postmenopausal women with genitourinary symptoms of menopause (GSM) were enrolled into this prospective cohort study and underwent vaginal laser treatment using MonaLisa Touch (R) fractional CO (2) laser system. Patients received three vaginal laser treatments with 360 degrees probe 4 weeks apart. A three-component Pelvic Floor Distress Inventory (PFDI-20) validated questionnaire was filled out by each patient before each session and 4 weeks after the final treatment. Wilcoxon rank sum test was used to compare the before and after treatment scores. Results Pelvic Organ Prolapse Distress Inventory (POPDI-6) scores were not significantly different after the first treatment compared with baseline (mean +/- standard deviation [SD], 21 +/- 18 vs. 17 +/- 15, P = 0.44). However, each subsequent treatment resulted in further, statistically significant improvement in symptom scores (14 +/- 15, P = 0.03 and 13 +/- 13, P = 0.01, after the second and third treatments, respectively). Similarly, Urinary Distress Inventory (UDI-6) scores were not significantly different after the first laser treatment (mean +/- SD, 36 +/- 25 vs. 29 +/- 23, P = 0.36). After the second and third treatments there were significant improvement in the standardized scores (24 +/- 20, P = 0.03 and 22 +/- 21, P = 0.01). Colorectal-Anal Distress Inventory (CRADI-8) scores did not change significantly after three laser treatments. Conclusions Three sessions of microablative fractional CO2 vaginal laser treatment significantly improves patient reported urinary and pelvic organ prolapse symptoms. Lasers Surg. Med. (c) 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.