{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:44:51Z","timestamp":1790372691873,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T00:00:00Z","timestamp":1737849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Biolitec\u00ae Biomedical Technology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Vaginal laser therapy is a promising treatment for menopausal vulvovaginal atrophy (VVA). This study evaluates the efficacy of a dual-wavelength diode laser (980 + 1470 nm) in treating VVA. Methods: Thirty postmenopausal patients with moderate-to-severe VVA were recruited, and twenty-nine completed the study. Patients underwent a screening visit (T0); three laser sessions at 4-week intervals (T1, T2, and T3); and a follow-up visit 4 weeks after the last treatment (T4). At T0 and T4, the Schiller test and Vaginal Maturation Index (VMI) were performed; sexual function was assessed through the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). At each visit, the Vaginal Health Index (VHI) and the Visual Analog Scale (VAS) for dyspareunia were administered. Potential side effects were investigated, and the VAS for the pain associated with the procedure was assessed. Data analysis included the overall group and two subgroups: women with (group A) and without (group B) a history of breast cancer (BC). Results: Significant improvements in the VHI and reduced dyspareunia were observed at T4 compared to T0 in all groups. The improvement was already seen after the first procedure, with further improvement after the other procedures, being persistent at the 1-month follow-up. The Schiller test showed significant improvements from T0 to T4 in all groups. The VMI showed a significant improvement from T0 to T4 in the overall group and group B. The FSFI questionnaires showed a significant improvement in all areas for the whole population, whereas the FDSF-R questionnaire showed an improvement only in the overall group. Procedural pain was low (mean VAS 1.6), and no side effects were reported. Conclusions: The dual-wavelength diode laser is an effective and safe option for the treatment of VVA in patients with and without a history of BC.<\/jats:p>","DOI":"10.3390\/jcm14030801","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T07:54:08Z","timestamp":1738050848000},"page":"801","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of the Efficacy and Safety of a Dual-Wavelength Diode Laser System for the Treatment of Vulvovaginal Atrophy in Women Without a History of Breast Cancer and in Patients with a History of Breast Cancer"],"prefix":"10.3390","volume":"14","author":[{"given":"Gaetano","family":"Perrini","sequence":"first","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Largo Turati 62, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-8669","authenticated-orcid":false,"given":"Silvia","family":"Actis","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Giorgi","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0456-874X","authenticated-orcid":false,"given":"Francesca","family":"Accomasso","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8376-5134","authenticated-orcid":false,"given":"Carola","family":"Minella","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Fava","sequence":"additional","affiliation":[{"name":"Pathological Anatomy Unit, Mauriziano Umberto I Hospital, Largo Turati 62, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Bisconte","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"De Rosa","sequence":"additional","affiliation":[{"name":"Pathological Anatomy Unit, Mauriziano Umberto I Hospital, Largo Turati 62, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2909-3699","authenticated-orcid":false,"given":"Annamaria","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6826-4788","authenticated-orcid":false,"given":"Valentina Elisabetta","family":"Bounous","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.maturitas.2014.07.013","article-title":"Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women\u2019s Sexual Health and the North American Menopause Society","volume":"79","author":"Portman","year":"2014","journal-title":"Maturitas"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2147\/IJWH.S44579","article-title":"Impact of vulvovaginal health on postmenopausal women: A review of surveys on symptoms of vulvovaginal atrophy","volume":"5","author":"Parish","year":"2013","journal-title":"Int. J. Womens Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1111\/jsm.12190","article-title":"Vulvar and vaginal atrophy in postmenopausal women: Findings from the REVIVE (Real Women\u2019s Views of Treatment Options for Menopausal Vaginal Changes) survey","volume":"10","author":"Kingsberg","year":"2013","journal-title":"J. Sex. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/gme.0b013e3181a95581","article-title":"Efficacy and tolerability of local estrogen therapy for urogenital atrophy","volume":"17","author":"Archer","year":"2010","journal-title":"Menopause"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"The North American Menopause Society (NAMS) (2013). Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause, 20, 888\u2013902.","DOI":"10.1097\/GME.0b013e3182a122c2"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.clbc.2015.06.005","article-title":"Genitourinary syndrome of menopause in breast cancer survivors: Are we facing new and safe hopes?","volume":"15","author":"Biglia","year":"2015","journal-title":"Clin. Breast Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.2147\/IJWH.S414509","article-title":"Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy","volume":"15","author":"Cucinella","year":"2023","journal-title":"Int. J. Womens Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.jmig.2020.08.001","article-title":"The efficacy of vaginal laser and other energy-based treatments on genital symptoms in postmenopausal women: A systematic review and meta-analysis","volume":"28","author":"Li","year":"2021","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2232563","DOI":"10.1001\/jamanetworkopen.2022.32563","article-title":"Comparison of severity of genitourinary syndrome of menopause symptoms after carbon dioxide laser vs vaginal estrogen therapy: A systematic review and meta-analysis","volume":"5","author":"Jang","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jsxm.2021.12.010","article-title":"CO2-laser therapy and genitourinary syndrome of menopause: A systematic review and meta-analysis","volume":"19","author":"Filippini","year":"2022","journal-title":"J. Sex. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.maturitas.2017.06.029","article-title":"Laser therapy for genitourinary syndrome of menopause: A systematic review and meta-analysis","volume":"103","author":"Pitsouni","year":"2017","journal-title":"Maturitas"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00404-016-4232-5","article-title":"Feasibility of hysteroscopic endometrial polypectomy using a new dual wavelengths laser system (DWLS): Preliminary results of a pilot study","volume":"295","author":"Nappi","year":"2017","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Haimovich, S., L\u00f3pez-Yarto, M., \u00c1vila, J.U., Guill\u00e9n, J., Gaspar, E., and Monle\u00f3n, J. (2015). Office hysteroscopic laser enucleation of submucous myomas without mass extraction: A case series study. Biomed Res. Int., 2015.","DOI":"10.1155\/2015\/905204"},{"key":"ref_14","first-page":"2474-1353","article-title":"Histological modifications of postmenopausal vaginal mucosa after regenerative solid-state laser treatment: A multicenter study","volume":"5","author":"Dodero","year":"2019","journal-title":"Int. J. Womens Health Wellness"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Barba, M., Cola, A., De Vicari, D., Trizzino, A., Pepe, F., Nappi, L., and Salvatore, S. (2023). Efficacy of a diode vaginal laser in the treatment of the genitourinary syndrome of menopause. Bioengineering, 10.","DOI":"10.3390\/bioengineering10101158"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1111\/j.1743-6109.2009.01635.x","article-title":"Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction","volume":"7","author":"Isidori","year":"2010","journal-title":"J. Sex. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1743-6109.2007.00672.x","article-title":"Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder","volume":"5","author":"Derogatis","year":"2008","journal-title":"J. Sex. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/gme.0b013e31816c5541","article-title":"Vaginal maturation index self-sample collection in mid-life women: Acceptability and correlation with physician-collected samples","volume":"15","author":"Hess","year":"2008","journal-title":"Menopause"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/0378-5122(95)00956-6","article-title":"Urogenital ageing: An old problem newly recognized","volume":"22","author":"Bachmann","year":"1995","journal-title":"Maturitas"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"The NAMS 2020 GSM Position Statement Editorial Panel (2020). The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause, 27, 976\u2013992.","DOI":"10.1097\/GME.0000000000001609"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1080\/13697137.2023.2225766","article-title":"Vaginal laser therapy for GSM\/VVA: Where we stand now\u2014A review by the EUGA Working Group on Laser","volume":"26","author":"Salvatore","year":"2023","journal-title":"Climacteric"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1097\/AOG.0000000000004601","article-title":"Treatment of Urogenital Symptoms in Individuals With a History of Estrogen-dependent Breast Cancer: Clinical Consensus","volume":"138","author":"Evans","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.maturitas.2016.09.012","article-title":"Microablative fractional CO2-laser therapy and the genitourinary syndrome of menopause: An observational study","volume":"94","author":"Pitsouni","year":"2016","journal-title":"Maturitas"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1097\/GME.0000000000000700","article-title":"An assessment of the safety and efficacy of a fractional CO2 laser system for the treatment of vulvovaginal atrophy","volume":"23","author":"Sokol","year":"2016","journal-title":"Menopause"},{"key":"ref_25","doi-asserted-by":"crossref","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":"ref_26","doi-asserted-by":"crossref","first-page":"2203","DOI":"10.1007\/s10103-021-03484-x","article-title":"The Er:YAG vaginal laser for management of women with genitourinary syndrome of menopause (GSM)","volume":"37","author":"Lin","year":"2022","journal-title":"Lasers Med. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1111\/1471-0528.16558","article-title":"Vaginal Er:YAG laser application in the menopausal ewe model: A randomized estrogen and sham-controlled trial","volume":"128","author":"Mackova","year":"2021","journal-title":"BJOG"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1080\/13697137.2020.1804544","article-title":"Sexual function after vaginal erbium laser: The results of a large, multicentric, prospective study","volume":"23","author":"Gambacciani","year":"2020","journal-title":"Climacteric"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s10103-023-03798-y","article-title":"A study of the objective benefits and safety of Er-YAG laser in the treatment of genitourinary syndrome of menopause","volume":"38","author":"Avul","year":"2023","journal-title":"Lasers Med. Sci."},{"key":"ref_30","first-page":"407","article-title":"Sexual function of women with chronic illness and cancer","volume":"6","author":"Basson","year":"2010","journal-title":"Women\u2019s Health"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Sousa Rodrigues Guedes, T., Barbosa Otoni Gon\u00e7alves Guedes, M., de Castro Santana, R., Costa da Silva, J.F., Almeida Gomes Dantas, A., Ochandorena-Acha, M., Terradas-Monllor, M., Jerez-Roig, J., and Bezerra de Souza, D.L. (2022). Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191911921"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"107950","DOI":"10.1016\/j.maturitas.2024.107950","article-title":"Vulvovaginal atrophy in women with and without a history of breast cancer: Baseline data from the PatiEnt satisfactiON studY (PEONY) in Italy","volume":"183","author":"Meriggiola","year":"2024","journal-title":"Maturitas"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5306\/wjco.v13.i2.71","article-title":"Management of genitourinary syndrome of menopause in breast cancer survivors: An update","volume":"13","year":"2022","journal-title":"World J. Clin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lubi\u00e1n-L\u00f3pez, D.M., Butr\u00f3n-Hinojo, C.A., Menj\u00f3n-Beltr\u00e1n, S., Gonz\u00e1lez-Mesa, E., Tapiador-Albertos, S., Rodr\u00edguez-Jim\u00e9nez, B., and Fiol-Ruiz, G. (2023). Effects of Non-Ablative Solid-State Vaginal Laser (SSVL) for the Treatment of Vulvovaginal Atrophy in Breast Cancer Survivors after Adjuvant Aromatase Inhibitor Therapy: Preliminary Results. J. Clin. Med., 12.","DOI":"10.3390\/jcm12175669"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/801\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:19Z","timestamp":1759919779000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,26]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030801"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030801","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,26]]}}}