(Poster 43) CO₂ Laser with Platelet-Rich Plasma in Genitourinary Syndrome of Menopause

Objectives: Genitourinary syndrome of menopause (GSM) severely affects postmenopausal women's quality of life by causing symptoms including vaginal dryness, irritation, and urinary discomfort. Innovations such as CO₂ laser therapy and autologous platelet-rich plasma (PRP) injections have demonstrated promising outcomes in alleviating GSM symptoms. This pilot study assesses the efficacy and safety of combining fractional CO₂ laser therapy with platelet-rich plasma (PRP) injections versus CO₂ laser therapy alone in treating GSM symptoms.

Methods: Twenty postmenopausal women suffering from GSM were divided into two groups. The first group (n=10) received three sessions of CO₂ laser therapy combined with PRP injections, while the second group (n=10) underwent three CO₂ laser sessions alone. Sessions were conducted at four-week intervals. The effectiveness of treatments was evaluated using the Vaginal Health Index (VHI), vaginal pH, and patient satisfaction scores.

Results: Both treatment groups exhibited significant improvements in pH levels (PRP+CO2 group: 5.880 vs 5.230, p=0.004 and CO2 group: 6.01 vs 5.640, p=0.02) and VHI score (PRP+CO2 group: 10.8 vs 15.9, p= 0.008 and CO2 group: 11.60 vs 14.30, p< 0.001) at the completion of the therapy. However, there was no statistically significant difference in the improvement between the groups for both pH and VHI score (p=0.322 and p=0.456, respectively). Patient satisfaction scores increased comparably in both groups after the treatment sessions.

Conclusions: The use of fractional CO₂ laser therapy in combination with PRP injections or alone effectively improved vaginal health and alleviated the symptoms of GSM. The addition of PRP to CO₂ laser therapy was not found to yield additional benefits. Larger, more comprehensive studies with longer follow-up periods are recommended to explore the potential advantages of combination therapy in specific subgroups of patients.