{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:08:36Z","timestamp":1791922116117,"version":"4.3.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":79,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the 12-month efficacy of a novel non-ablative dual Nd:YAG\/Er:YAG laser therapy for vulvar lichen sclerosus (LS) and to evaluate the impact of crossover laser treatment following initial topical corticosteroid therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study presents the 1-year data of a prospective observational trial. Between baseline and 6\u00a0months, women with vulvar LS were randomized to receive either dual Nd:YAG\/Er:YAG laser therapy or topical clobetasol propionate. Between 6 and 12\u00a0months, optional steroid or laser therapies were offered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the laser group, 34 of 44 patients (77%) required no additional treatment between 6 and 12\u00a0months, indicating sustained treatment effects. The total LS score improved significantly during this period (mean change\u2009-0.35\u2009\u00b1\u20090.60; 95% CI\u2009-0.56 to\u2009-0.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), while other parameters showed non-significant improvements. In the corticosteroid group, 20 of 22 patients (91%) opted for a crossover to laser therapy. Following three laser sessions, the total LS score improved markedly (mean change\u2009-1.50\u2009\u00b1\u20090.83; 95% CI\u2009-1.89 to\u2009-1.11;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), primarily driven by a reduction in atrophy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patient-reported improvement (PGI-I) increased from 45 to 77% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). At the 12-month follow-up, outcomes were comparable between the two study groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Non-ablative dual Nd:YAG\/Er:YAG laser therapy resulted in significant and sustained clinical improvement in vulvar LS over 12\u00a0months. Crossover to laser therapy after initial corticosteroid treatment further enhanced both objective and subjective outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial identification number<\/jats:title>\n                    <jats:p>NCT03926299; date of registration: 24 April 2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08510-3","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:28:35Z","timestamp":1782880115000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["One-year outcome after laser treatment of vulvar lichen sclerosus: a prospective observational trial"],"prefix":"10.1007","volume":"313","clinical-trial-number":[{"clinical-trial-number":"nct03926299","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-1239","authenticated-orcid":false,"given":"Marianne","family":"Gamper","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena","family":"Zivanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Bischofberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1116-8912","authenticated-orcid":false,"given":"Volker","family":"Viereck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"8510_CR1","doi-asserted-by":"publisher","first-page":"1850","DOI":"10.1111\/jdv.20082","volume":"38","author":"G Kirtschig","year":"2024","unstructured":"Kirtschig G, Kinberger M, Kreuter A et al (2024) EuroGuiderm guideline on lichen sclerosus\u2014introduction into lichen sclerosus. J Eur Acad Dermatol Venereol 38:1850\u20131873. https:\/\/doi.org\/10.1111\/jdv.20082","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"8510_CR2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1097\/AOG.0000000000005635","volume":"144","author":"CB Iglesia","year":"2024","unstructured":"Iglesia CB, Choi JE, Tadir Y (2024) Lasers in gynecology. Obstet Gynecol 144:181\u2013194. https:\/\/doi.org\/10.1097\/AOG.0000000000005635","journal-title":"Obstet Gynecol"},{"key":"8510_CR3","doi-asserted-by":"publisher","first-page":"1106318","DOI":"10.3389\/fmed.2023.1106318","volume":"10","author":"DA De Luca","year":"2023","unstructured":"De Luca DA, Papara C, Vorobyev A et al (2023) Lichen sclerosus: the 2023 update. Front Med (Lausanne) 10:1106318. https:\/\/doi.org\/10.3389\/fmed.2023.1106318","journal-title":"Front Med (Lausanne)"},{"key":"8510_CR4","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1097\/GME.0000000000002478","volume":"32","author":"I Zivanovic","year":"2025","unstructured":"Zivanovic I, Gamper M, Fesslmeier D, Bischofberger H, Viereck V (2025) A randomized controlled trial to evaluate a novel dual laser therapy for vulvar lichen sclerosus: Exploratory study assessing the impact of menopausal status. Menopause 32:228\u2013233. https:\/\/doi.org\/10.1097\/GME.0000000000002478","journal-title":"Menopause"},{"key":"8510_CR5","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jamadermatol.2015.0643","volume":"151","author":"A Lee","year":"2015","unstructured":"Lee A, Bradford J, Fischer G (2015) Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatol 151:1061\u20131067. https:\/\/doi.org\/10.1001\/jamadermatol.2015.0643","journal-title":"JAMA Dermatol"},{"key":"8510_CR6","doi-asserted-by":"publisher","first-page":"950","DOI":"10.3390\/biomedicines9080950","volume":"9","author":"M Corazza","year":"2021","unstructured":"Corazza M, Schettini N, Zedde P, Borghi A (2021) Vulvar lichen sclerosus from pathophysiology to therapeutic approaches: evidence and prospects. Biomedicines 9:950. https:\/\/doi.org\/10.3390\/biomedicines9080950","journal-title":"Biomedicines"},{"key":"8510_CR7","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1016\/j.jogc.2019.01.023","volume":"41","author":"U Bizjak Ogrinc","year":"2019","unstructured":"Bizjak Ogrinc U, Sencar S, Luzar B, Lukanovic A (2019) Efficacy of non-ablative laser therapy for lichen sclerosus: a randomized controlled trial. J Obstet Gynaecol Can 41:1717\u20131725. https:\/\/doi.org\/10.1016\/j.jogc.2019.01.023","journal-title":"J Obstet Gynaecol Can"},{"key":"8510_CR8","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1111\/aogs.14353","volume":"101","author":"OE Mortensen","year":"2022","unstructured":"Mortensen OE, Christensen SE, Lokkegaard E (2022) The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: a state-of-the-art review. Acta Obstet Gynecol Scand 101:657\u2013692. https:\/\/doi.org\/10.1111\/aogs.14353","journal-title":"Acta Obstet Gynecol Scand"},{"key":"8510_CR9","doi-asserted-by":"publisher","first-page":"2146","DOI":"10.3390\/life13112146","volume":"13","author":"A Gil-Villalba","year":"2023","unstructured":"Gil-Villalba A, Ayen-Rodriguez A, Naranjo-Diaz MJ, Ruiz-Villaverde R (2023) Laser therapy for vulvar lichen sclerosus, a systematic review. Life 13:2146. https:\/\/doi.org\/10.3390\/life13112146","journal-title":"Life"},{"key":"8510_CR10","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1111\/1471-0528.17737","volume":"131","author":"I Zivanovic","year":"2024","unstructured":"Zivanovic I, Gamper M, Fesslmeier D, Walser C, Regauer S, Viereck V (2024) Nd:YAG\/Er:YAG dual laser compared with topical steroid to treat vulvar lichen sclerosus: a randomised controlled trial. BJOG 131:740\u2013749. https:\/\/doi.org\/10.1111\/1471-0528.17737","journal-title":"BJOG"},{"key":"8510_CR11","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1097\/AOG.0000000000004332","volume":"137","author":"LS Burkett","year":"2021","unstructured":"Burkett LS, Siddique M, Zeymo A et al (2021) Clobetasol compared with fractionated carbon dioxide laser for lichen sclerosus: a randomized controlled trial. Obstet Gynecol 137:968\u2013978. https:\/\/doi.org\/10.1097\/AOG.0000000000004332","journal-title":"Obstet Gynecol"},{"key":"8510_CR12","doi-asserted-by":"publisher","first-page":"919135","DOI":"10.3389\/fsurg.2022.919135","volume":"9","author":"JQ Guo","year":"2022","unstructured":"Guo JQ, Chen SY, Chen XM et al (2022) Clinical study on multi-focused laser in the treatment of vulvar lichen sclerosus. Front Surg 9:919135. https:\/\/doi.org\/10.3389\/fsurg.2022.919135","journal-title":"Front Surg"},{"key":"8510_CR13","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s13104-023-06300-7","volume":"16","author":"HC Salgado","year":"2023","unstructured":"Salgado HC, Drumond DG, Pannain GD, de Melo ECLG, Sampaio FS, Leite ICG (2023) Randomized clinical trial with fractional CO2 laser and clobetasol in the treatment of vulvar lichen sclerosus: a clinic study of feasibility. BMC Res Notes 16:33. https:\/\/doi.org\/10.1186\/s13104-023-06300-7","journal-title":"BMC Res Notes"},{"key":"8510_CR14","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.70062","author":"D Wei","year":"2025","unstructured":"Wei D, Meng J, Li Q, Wang Y, Chen Y, Niu X (2025) Efficacy and safety of laser treatment in vulvar lichen sclerosus: a systematic review. Lasers Surg Med. https:\/\/doi.org\/10.1002\/lsm.70062","journal-title":"Lasers Surg Med"},{"key":"8510_CR15","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1007\/s00404-023-07055-z","volume":"308","author":"V Viereck","year":"2023","unstructured":"Viereck V, Gamper M, Regauer S, Walser C, Zivanovic I (2023) Nd:YAG\/Er:YAG dual laser vs. topical steroid to treat vulvar lichen sclerosus: Study protocol of a randomized controlled trial. Arch Gynecol Obstet 308:643\u2013649. https:\/\/doi.org\/10.1007\/s00404-023-07055-z","journal-title":"Arch Gynecol Obstet"},{"key":"8510_CR16","doi-asserted-by":"publisher","first-page":"2342","DOI":"10.1111\/j.1743-6109.2012.02814.x","volume":"9","author":"AR G\u00fcnthert","year":"2012","unstructured":"G\u00fcnthert AR, Duclos K, Jahns BG et al (2012) Clinical scoring system for vulvar lichen sclerosus. J Sex Med 9:2342\u20132350. https:\/\/doi.org\/10.1111\/j.1743-6109.2012.02814.x","journal-title":"J Sex Med"},{"key":"8510_CR17","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1016\/j.jsxm.2020.06.021","volume":"17","author":"AR G\u00fcnthert","year":"2020","unstructured":"G\u00fcnthert AR (2020) Clinical scoring system for vulvar lichen sclerosus. Erratum. J Sex Med. 17:1825. https:\/\/doi.org\/10.1016\/j.jsxm.2020.06.021","journal-title":"Erratum. J Sex Med."},{"key":"8510_CR18","doi-asserted-by":"publisher","first-page":"174","DOI":"10.4103\/0253-7184.167169","volume":"36","author":"S Naswa","year":"2015","unstructured":"Naswa S, Marfatia YS (2015) Physician-administered clinical score of vulvar lichen sclerosus: a study of 36 cases. Indian J Sex Transm Dis AIDS 36:174\u2013177. https:\/\/doi.org\/10.4103\/0253-7184.167169","journal-title":"Indian J Sex Transm Dis AIDS"},{"key":"8510_CR19","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1097\/AOG.0000000000004409","volume":"137","author":"L Mitchell","year":"2021","unstructured":"Mitchell L, Goldstein AT, Heller D et al (2021) Fractionated carbon dioxide laser for the treatment of vulvar lichen sclerosus: a randomized controlled trial. Obstet Gynecol 137:979\u2013987. https:\/\/doi.org\/10.1097\/AOG.0000000000004409","journal-title":"Obstet Gynecol"},{"key":"8510_CR20","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.ejogrb.2023.06.003","volume":"287","author":"E Krause","year":"2023","unstructured":"Krause E, Neumann S, Maier M et al (2023) LASER treatment in gynaecology\u2014a randomized controlled trial in women with symptomatic lichen sclerosus. Eur J Obstet Gynecol Reprod Biol 287:171\u2013175. https:\/\/doi.org\/10.1016\/j.ejogrb.2023.06.003","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"8510_CR21","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1111\/jdv.20083","volume":"38","author":"G Kirtschig","year":"2024","unstructured":"Kirtschig G, Kinberger M, Kreuter A et al (2024) EuroGuiderm guideline on lichen sclerosus\u2014treatment of lichen sclerosus. J Eur Acad Dermatol Venereol 38:1874\u20131909. https:\/\/doi.org\/10.1111\/jdv.20083","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"8510_CR22","first-page":"28","volume":"65","author":"W Mendling","year":"2024","unstructured":"Mendling W (2024) Lichen planus of the vulva. Frauenarzt 65:28\u201334","journal-title":"Frauenarzt"},{"key":"8510_CR23","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1097\/GME.0b013e318282600b","volume":"20","author":"EA Erekson","year":"2013","unstructured":"Erekson EA, Yip SO, Wedderburn TS et al (2013) The vulvovaginal symptoms questionnaire: a questionnaire for measuring vulvovaginal symptoms in postmenopausal women. Menopause 20:973\u2013979. https:\/\/doi.org\/10.1097\/GME.0b013e318282600b","journal-title":"Menopause"},{"key":"8510_CR24","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/GME.0000000000000549","volume":"23","author":"EA Erekson","year":"2016","unstructured":"Erekson EA, Li FY, Martin DK, Fried TR (2016) Vulvovaginal symptoms prevalence in postmenopausal women and relationship to other menopausal symptoms and pelvic floor disorders. Menopause 23:368\u2013375. https:\/\/doi.org\/10.1097\/GME.0000000000000549","journal-title":"Menopause"},{"key":"8510_CR25","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00192-009-1069-5","volume":"21","author":"S Srikrishna","year":"2010","unstructured":"Srikrishna S, Robinson D, Cardozo L (2010) Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J 21:523\u2013528. https:\/\/doi.org\/10.1007\/s00192-009-1069-5","journal-title":"Int Urogynecol J"},{"key":"8510_CR26","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/lsm.20587","volume":"40","author":"H Liu","year":"2008","unstructured":"Liu H, Dang Y, Wang Z, Chai X, Ren Q (2008) Laser induced collagen remodeling: a comparative study in vivo on mouse model. Lasers Surg Med 40:13\u201319. https:\/\/doi.org\/10.1002\/lsm.20587","journal-title":"Lasers Surg Med"},{"key":"8510_CR27","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1002\/lsm.22304","volume":"46","author":"J Tan","year":"2014","unstructured":"Tan J, Lei Y, Ouyang HW, Gold MH (2014) The use of the fractional CO2 laser resurfacing in the treatment of photoaging in Asians: five years long-term results. Lasers Surg Med 46:750\u2013756. https:\/\/doi.org\/10.1002\/lsm.22304","journal-title":"Lasers Surg Med"},{"key":"8510_CR28","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1007\/s10517-017-3784-0","volume":"163","author":"GA Lapii","year":"2017","unstructured":"Lapii GA, Yakovleva AY, Neimark AI, Lushnikova EL (2017) Study of proliferative activity of vaginal epithelium in women with stress urinary incontinence treated by Er:YAG laser. Bull Exp Biol Med 163:280\u2013283. https:\/\/doi.org\/10.1007\/s10517-017-3784-0","journal-title":"Bull Exp Biol Med"},{"key":"8510_CR29","first-page":"22","volume":"1","author":"M Lukac","year":"2011","unstructured":"Lukac M, Vizintin Z, Pirnat S, Nemes K (2011) New skin treatment possibilities with PIANO mode on an Nd:YAG laser. J Las Health Acad 1:22\u201332","journal-title":"J Las Health Acad"},{"key":"8510_CR30","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.1007\/s10103-021-03474-z","volume":"37","author":"A Gaspar","year":"2022","unstructured":"Gaspar A, Koron N, Silva J, Brandi H (2022) Vaginal erbium laser for treatment of stress urinary incontinence: optimization of treatment regimen for a sustained long-term effect. Lasers Med Sci 37:2157\u20132164. https:\/\/doi.org\/10.1007\/s10103-021-03474-z","journal-title":"Lasers Med Sci"},{"key":"8510_CR31","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1007\/s00192-019-04148-9","volume":"31","author":"A Kuszka","year":"2020","unstructured":"Kuszka A, Gamper M, Walser C, Kociszewski J, Viereck V (2020) Erbium:YAG laser treatment of female stress urinary incontinence: midterm data. Int Urogynecol J 31:1859\u20131866. https:\/\/doi.org\/10.1007\/s00192-019-04148-9","journal-title":"Int Urogynecol J"},{"key":"8510_CR32","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1007\/s00192-025-06076-3","volume":"36","author":"AS Seki","year":"2025","unstructured":"Seki AS, de Mello Bianchi-Ferraro AMH, Bonetti TCS, Fonseca ESM, Sartori MGF, de Jarmy-Di Bella ZIK (2025) How long does urinary continence last after treatment with intravaginal CO(2) laser and microablative radiofrequency? A four-year follow-up of a multi-arm randomized clinical trial (LARF-arm3). Int Urogynecol J 36:1971\u20131978. https:\/\/doi.org\/10.1007\/s00192-025-06076-3","journal-title":"Int Urogynecol J"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-026-08510-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-026-08510-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-026-08510-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:57:12Z","timestamp":1789693032000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-026-08510-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8510"],"URL":"https:\/\/doi.org\/10.1007\/s00404-026-08510-3","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"assertion":[{"value":"21 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received ethical approval (EKOS 19\/056, BASEC-ID: 2019-00634, 15 April 2019) and is registered at clinicaltrials.gov (NCT03926299, 24 April 2019).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"271"}}