000			03231nam a22004697a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a0029-7844
024			_a00006250-990000000-01093 [pii]
040			_aOvid MEDLINE(R)
099			_a38843530
245			_aLasers in Gynecology. [Review]
251			_aObstetrics & Gynecology. 144(2):181-194, 2024 Aug 01.
252			_aObstet Gynecol. 144(2):181-194, 2024 Aug 01.
253			_aObstetrics and gynecology
260			_c2024
260			_fFY2024
260			_p2024 Aug 01
265			_sppublish
265			_tMEDLINE
266			_d2024-08-07
266			_z2024/06/06 17:03
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aThe 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.
546			_aEnglish
650			_a*Laser Therapy
650			_aFemale
650			_aHumans
650			_aLaser Therapy/mt [Methods]
650			_aLichen Sclerosus et Atrophicus
650			_aUrinary Incontinence/su [Surgery]
650			_aVaginal Diseases/su [Surgery]
650			_aVulvar Diseases/su [Surgery]
650			_zAutomated
651			_aMedStar Washington Hospital Center
656			_aObstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
657			_aJournal Article
657			_aReview
700			_aIglesia, Cheryl B _bMWHC
790			_aIglesia CB, Choi JE, Tadir Y
856			_uhttps://dx.doi.org/10.1097/AOG.0000000000005635 _zhttps://dx.doi.org/10.1097/AOG.0000000000005635
942			_cART _dArticle
999			_c14529 _d14529