{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T08:55:43Z","timestamp":1753520143628,"version":"3.40.5"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>To evaluate the safety and efficacy of transvaginal fractional microablative CO<jats:sub>2<\/jats:sub> laser therapy (MLT) on urinary symptoms in postmenopausal women with genitourinary syndrome of menopause (GSM) in relation to the timing of their onset; if prior to or after menopause. Secondary, the efficacy of MLT on vulvovaginal atrophy (VVA)\u2010related symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Materials and Methods<\/jats:title><jats:p>This is a retrospective analysis of prospectively collected data. Postmenopausal women affected by at least one urinary symptom (urinary frequency, urgency incontinence, stress urinary incontinence) and VVA symptom each (dryness, dyspareunia, itching, burning) were enrolled. Our population was divided into two groups in relation to the onset of urinary symptoms, prior to or after menopause. Women were treated with three CO<jats:sub>2<\/jats:sub> MLT laser sessions, administered at a 4\u2010week interval. For urinary symptoms evaluation, we used the following disease\u2010specific questionnaires previously validated in Italy: the Urogenital Distress Inventory score (UDI\u20106) and the International Consultation on Incontinence Questionnaire\u2010Short Form (ICIQ\u2010SF). For each single VVA symptom, we assessed patient's severity perception with a 10\u2010point visual analog scale. Time points of the study were at entry (T0) and at 16 weeks since the first treatment (T1). Collected data were analyzed with the Pearson <jats:italic>\u03c7<\/jats:italic>\n<jats:sup>2<\/jats:sup> test for categorical variables and the Wilcoxon rank\u2010sum test (for non\u2010normally distributed data), and statistical significance was defined with a <jats:italic>P<\/jats:italic>\u2010value &lt;0.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010one women were enrolled in this study. Overall, at T1 MLT brought to a significant improvement in urinary symptoms (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) in women with urinary symptoms started after the menopause (Group B), contrary to the ones with urinary symptoms started before the menopause (Group A). Specifically, urinary frequency significantly improved only in Group B (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), while urgency incontinence, significantly reduced in both groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Stress urinary incontinence did not significantly improve in both groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). Secondary, all VVA symptoms showed a statistically significant improvement (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) at 16 weeks from baseline; no differences were registered between groups. No adverse events were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirms the safety and efficacy of CO<jats:sub>2<\/jats:sub> MLT for GSM symptoms. When urinary symptoms are considered, it seems that MLT might have a higher efficacy when symptoms started after menopause, in particular when they are part of the OAB syndrome. Lasers Surg. Med. \u00a9 2021 Wiley Periodicals LLC<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23378","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T19:33:25Z","timestamp":1611257605000},"page":"953-959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Does the Time of Onset of Urinary Symptoms Affect Microablative Fractional CO<sub>2<\/sub> Laser Efficacy in Postmenopausal Women?"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-523X","authenticated-orcid":false,"given":"Alessandro F.","family":"Ruffolo","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan 20132 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Casiraghi","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan 20132 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Marotta","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan 20132 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Degliuomini","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan 20132 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Parma","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan 20132 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