{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:19:36Z","timestamp":1791487176477,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","award":["R325\u2010A18816"],"award-info":[{"award-number":["R325\u2010A18816"]}],"id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Breast cancer survivors (BCSs) receiving endocrine therapy frequently develop genitourinary syndrome of menopause, characterized by vaginal dryness, pain, and urinary symptoms. Fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      vaginal laser therapy has been proposed as a non\u2010hormonal management option, but the optimal number of treatment sessions remains unclear. As preparation for a forthcoming randomized, blinded, sham\u2010controlled trial, this dose\u2010determining study evaluated how the number of fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser sessions influences urogenital symptoms and objective vaginal parameters to identify session\u2010dependent dose\u2013response patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center dose\u2010determining study was conducted at Randers Regional Hospital, Denmark. Thirty BCSs on endocrine therapy with symptomatic genitourinary syndrome of menopause underwent five monthly sessions of fractional microablative CO\n                      <jats:sub>2<\/jats:sub>\n                      vaginal laser using a standardized intravaginal probe protocol. Outcomes were evaluated at baseline and 4 weeks after the third, fourth, and fifth sessions. The primary outcome was vaginal dryness (VAS 0\u201310). Secondary outcomes included vaginal pain, itching, and soreness (VAS); sexual function (FSFI, SCS\u2010W); urinary symptoms (UDI\u20106, ICIQ\u2010FLUTSsex); and vaginal health (VHI). Statistical analyses involved paired within\u2010participant comparisons across time points.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010seven participants (90%) completed all five sessions. Vaginal dryness decreased significantly after three treatments, with a further incremental reduction by the fifth, representing the largest session\u2010dependent change. FSFI scores increased significantly from baseline, with additional improvements across later sessions. SCS\u2010W and ICIQ\u2010FLUTSsex scores decreased steadily, while UDI\u20106 improved from baseline but remained stable across subsequent assessments. Treatments were well tolerated, with no serious adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      vaginal laser therapy demonstrated incremental, session\u2010dependent changes in urogenital symptoms and vaginal health measures, with the greatest improvements after five sessions. The protocol was feasible and acceptable for BCSs receiving endocrine therapy. Overall, these findings provide clinically relevant dose\u2013response insight to help guide optimization of treatment parameters ahead of future randomized, sham\u2010controlled trials overall.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lsm.70187","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:20:56Z","timestamp":1787203256000},"page":"846-854","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vaginal Laser Treatment for Genitourinary Syndrome of the Menopause: A Dose\u2010Determining Study in Breast Cancer Survivors"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9500-5001","authenticated-orcid":false,"given":"Sine","family":"Jacobsen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Randers Regional Hospital Randers N\u00d8 Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Glavind\u2010Kristensen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders Bonde","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"},{"name":"Department of Oncology Aarhus University Hospital Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Forman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3663-9431","authenticated-orcid":false,"given":"Vibe Munk","family":"Bertelsen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Randers Regional Hospital Randers N\u00d8 Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Bor","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"},{"name":"Department of Obstetrics and Gynaecology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"American Cancer Society Key Statistics for Breast Cancer\u00a0(2024). 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