{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T16:27:20Z","timestamp":1773073640036,"version":"3.50.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Genitourinary syndrome of menopause (GSM) is a condition affecting peri and postmenopausal women. Er:YAG vaginal laser has been reported to improve symptoms through thermal remodeling, without tissue ablation. Exosomes are emerging biological mediators with regenerative and anti-inflammatory effects. Their use in combination with Er:YAG laser has not yet been extensively studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate safety and clinical efficacy of combining Er:YAG vaginal laser with topical intravaginal application of plant-derived exosomes (ASCEplus IRLV) for GSM symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty women aged 45-63 years with GSM were enrolled between June and December 2023. Inclusion criteria were GSM symptoms, exclusion criteria included active infection, hormone therapy, or pelvic malignancy. Patients underwent 4 sessions of Er:YAG laser (4 J, 3600 pulses, 4 weeks apart), followed by intravaginal topical intervaginal application of 4 mL ASCEplus IRLV. Outcomes were assessed at baseline, 3 and 6 months with the Vaginal Health Index (VHI) and Female Sexual Distress Scale\u2013Revised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Vaginal Health Index Scores improved significantly at 3 and 6 months. Female Sexual Distress Scale\u2013Revised scores decreased significantly at 3 and 6 months and stabilized thereafter. Subgroup analysis showed consistent benefit across different baseline VHI ranges. Patients reported improvements in vaginal dryness, dyspareunia, and mild urinary incontinence. No adverse events occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined Er:YAG laser and plant-derived exosomes is a safe, non-hormonal, regenerative option for GSM. The treatment improved vaginal symptoms, sexual function, and urinary complaints with durable effects. Larger controlled studies are needed to confirm these preliminary findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf243","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T12:52:05Z","timestamp":1763470325000},"page":"S89-S92","source":"Crossref","is-referenced-by-count":0,"title":["Erbium:YAG Laser Combined With Plant-Derived Exosomes (ASCEplus IRLV) for Genital Rejuvenation"],"prefix":"10.1093","volume":"46","author":[{"given":"Sophie","family":"Menkes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"2026030906374251000_sjaf243-B1","doi-asserted-by":"publisher","first-page":"757","DOI":"10.3109\/13697137.2015.1045485","article-title":"Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause","volume":"18","author":"Gambacciani","year":"2015","journal-title":"Climacteric"},{"key":"2026030906374251000_sjaf243-B2","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1080\/13697137.2020.1829584","article-title":"CO2 laser and the genitourinary syndrome of menopause: a randomized sham-controlled trial","volume":"24","author":"Salvatore","year":"2021","journal-title":"Climacteric"},{"key":"2026030906374251000_sjaf243-B3","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1002\/stem.2575","article-title":"Concise Review: MSC-derived exosomes for cell-free therapy","volume":"35","author":"Phinney","year":"2017","journal-title":"Stem Cells"},{"key":"2026030906374251000_sjaf243-B4","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1186\/s12967-020-02622-3","article-title":"Mesenchymal stem cell derived exosomes: a modern approach in translational medicine","volume":"18","author":"Nikfarjam","year":"2020","journal-title":"J Transl Med"},{"key":"2026030906374251000_sjaf243-B5","doi-asserted-by":"publisher","first-page":"5420463","DOI":"10.1155\/2018\/5420463","article-title":"Exosomal microRNAs derived from human amniotic epithelial cells accelerate wound healing by promoting fibroblast proliferation and migration","volume":"2018","author":"Zhao","year":"2018","journal-title":"Stem Cells Int"},{"key":"2026030906374251000_sjaf243-B6","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1080\/13697137.2018.1559806","article-title":"Rationale and design for fractional microablative CO2 laser versus photothermal non-ablative Er:YAG laser for GSM: a non-inferiority, single-blind randomized controlled trial (protocol)","volume":"22","author":"Flint","year":"2019","journal-title":"Climacteric"}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/46\/Supplement_1\/S89\/67279180\/sjaf243.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/46\/Supplement_1\/S89\/67279180\/sjaf243.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:37:47Z","timestamp":1773052667000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/46\/Supplement_1\/S89\/8512046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":6,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2026,3,9]]},"published-print":{"date-parts":[[2026,3,9]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjaf243","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,3,9]]}}}