TY  - BOOK
AU  - Iglesia, Cheryl B
TI  - Lasers in Gynecology. [Review]
SN  - 0029-7844
PY  - 2024///
KW  - *Laser Therapy
KW  - Female
KW  - Humans
KW  - Laser Therapy/mt [Methods]
KW  - Lichen Sclerosus et Atrophicus
KW  - Urinary Incontinence/su [Surgery]
KW  - Vaginal Diseases/su [Surgery]
KW  - Vulvar Diseases/su [Surgery]
KW  - Automated
KW  - MedStar Washington Hospital Center
KW  - Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
KW  - Journal Article
KW  - Review
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - The first published reports on the use of laser for cervical pathology date back to 1973. Technical advancements in flexible and rigid laser fibers revolutionized video laser laparoscopy in the 1990s. Fractionated lasers have been used to treat vulvovaginal symptoms associated with genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence. Review of available data suggests that fractionated lasers can improve both subjective and objective signs of vaginal atrophy and lichen sclerosus, but the evidence is weak because most of the trials are underpowered, are at risk for bias, and lack long-term follow-up. There is no strong evidence to support fractionated laser therapy for urinary incontinence or low-level laser therapy for chronic pelvic pain. Although short-term, single-arm trials suggest benefit of fractionated laser therapy for genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence, additional adequately powered, prospective, randomized, and longer-term comparative trials are needed before lasers can be recommended for these specific conditions. The purpose of this Clinical Expert Series is to review basic laser biophysics and the mechanism of action for modern fractionated lasers as relevant to the gynecologist. We also summarize safety and effectiveness data for lasers used for some of the most commonly studied gynecologic conditions: the vulvovaginal atrophy component of genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence. Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved
UR  - https://dx.doi.org/10.1097/AOG.0000000000005635
ER  -