{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:55Z","timestamp":1786978315138,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T00:00:00Z","timestamp":1587600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Candela lasers","award":["ClinicalTrials.gov Identifier: NCT02704741"],"award-info":[{"award-number":["ClinicalTrials.gov Identifier: NCT02704741"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>\n                      More studies are needed to assess the long\u2010term safety profile and clinical outcomes of lasers and energy\u2010based devices to treat the symptoms associated with vulvovaginal atrophy. This study evaluated a series of three fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser treatments to the vulva and vagina with a 1\u2010year follow\u2010up in a postmenopausal population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design\/Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, self\u2010controlled, open\u2010label clinical study, 18 postmenopausal females with atrophic vaginitis received 3 monthly treatments to the vulva and vagina with a fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser system and 1\u2010, 3\u2010, 6\u2010, and 12\u2010month follow\u2010up. Investigators used the Vaginal Health Index (VHI) to assess changes in vaginal elasticity, fluid volume, vaginal pH, epithelial integrity, and moisture. Sexual function at each timepoint was subject\u2010reported, using the validated Female Sexual Function Index (FSFI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Treatment of the vulva and vagina in postmenopausal women with fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser resurfacing resulted in statistically significant improvements as compared with baseline at all post\u2010treatment and follow\u2010up intervals to 12 months in VHI and FSFI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u20090.003 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u20090.03, respectively). Mean total VHI score increased from a baseline of 11.8\u201322.8 (93.2% improved) at 6\u2010month follow\u2010up (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0002) slightly decreasing to 21.4 (81.4% improved) at 12\u2010month follow\u2010up post\u2010treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0003). Mean FSFI Scores increased from a baseline of 17.9\u201326.3 (46.9% improvement) at 12\u2010month follow\u2010up post\u2010treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u20090.0048). Cohort analysis revealed restoration of normal or near\u2010normal (23\u201325) VHI following laser treatment in the recently menopausal (1\u20133 years) greatly exceeded that of the &gt;3 years postmenopausal population and the difference was statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u20090.05). Normal\/near\u2010normal VHI at 3\u2010, 6\u2010, and 12\u2010month post\u2010treatment was 88%, 88%, and 63% in the recently postmenopausal cohort, as compared with 30%, 40%, and 10% of the &gt;3 years postmenopausal group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u20090.05). Patient satisfaction following treatment was rated as high at 94% at 12\u2010month follow\u2010up. Safety findings demonstrated no\u2010to\u2010slight discomfort in the majority of subjects and transient erythema and edema, with no adverse events associated with treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser treatment of the vulva and vagina resulted in statistically significant improvements in VHI and FSFI compared with baseline in postmenopausal population that were sustained to 12\u2010month follow\u2010up. Restoration of normal VHI was observed in a statistically significant greater percentage in the recently postmenopausal cohort (1\u20133 years) as compared with postmenopausal cohort of &gt;3 years, suggesting that early intervention is correlated with improved outcomes. Lasers Surg. Med. \u00a9 2020 Wiley Periodicals, Inc.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lsm.23247","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:13:53Z","timestamp":1587687233000},"page":"185-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Fractional Co\n                    <sub>2<\/sub>\n                    Laser Treatment of the Vulva and Vagina and the Effect of Postmenopausal Duration on Efficacy"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-9537","authenticated-orcid":false,"given":"Macrene R.","family":"Alexiades","sequence":"first","affiliation":[{"name":"Dermatology and Laser Surgery Center of New York Yale University School of Medicine  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.22637"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23031"},{"issue":"11","key":"e_1_2_7_4_1","first-page":"1155","article-title":"Lasers and energy\u2010based devices for Women's Genitourinary Health: Scientific and clinical evidence and FDA clearance","volume":"17","author":"Alexiades M","year":"2018","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.12788\/j.sder.2018.052"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2018.1446930"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjy087"},{"issue":"11","key":"e_1_2_7_8_1","first-page":"1085","article-title":"n\u2010Vivo histological analysis of a fractional CO2 laser system intended for treatment of soft tissue","volume":"16","author":"Hurliman E","year":"2017","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-5122(95)00956-6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/009262300278597"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.3877"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000000756"},{"key":"e_1_2_7_13_1","first-page":"099","article-title":"Histological modifications of postmenopausal vaginal mucosa after regenerative solid state laser treatment: A multicenter study","volume":"5","author":"Dodero D","year":"2019","journal-title":"Int J Womens Health Wellness"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2015.1071126"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.4236\/jct.2017.85039"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001206"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.10.048"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flsm.23247","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.23247","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lsm.23247","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.23247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T19:54:02Z","timestamp":1693684442000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.23247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,23]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1002\/lsm.23247"],"URL":"https:\/\/doi.org\/10.1002\/lsm.23247","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,23]]},"assertion":[{"value":"2020-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}