E-Posters-Histopathological Changes in the Vaginal Integument after CO2 Ablational Fractional Laser Treatment in women with a Treatment History of POP using Vaginal Mesh Repair

Histopathological Changes in the Vaginal Integument after CO2 Ablational Fractional Laser Treatment in women with a Treatment History of POP using Vaginal Mesh Repair - Maki Nakata, MD

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This study examined the histopathological changes in the vaginal integument after CO2 ablational fractional laser treatment (AFLT) in women with a history of pelvic organ prolapse (POP) and vaginal mesh repair. The researchers recruited women who had post-menopausal vulvovaginal atrophy and were experiencing discomfort or urinary tract symptoms. The participants received three sessions of vaginal AFLT using a specific laser equipment. The effects and adverse events were evaluated through self-administered questionnaires. <br /><br />The histopathological evaluation revealed that chronic vulvovaginitis with atrophic degenerative changes and inflammation were commonly observed in women with POP. The inflammatory process led to fibrosis of the lamina propria and atrophy of the stratified squamous epithelium. <br /><br />The results showed that vaginal CO2 AFLT can be safely performed in women post-VMR without new mesh exposure. Some participants reported beneficial changes in their local and urinary symptoms. However, it is unclear whether vaginal CO2 AFLT is effective in reorganizing damaged histological structures, especially in cases with advanced genitourinary syndrome of menopause (GSM) and polypropylene mesh placed close to the vagina.<br /><br />The study also included subjective evaluations from the participants, who reported relief in vulvovaginal and/or urinary symptoms following the treatment. The histopathological evaluation showed a slight progression of mucosal layer atrophy and fibrosis of the lamina propria after treatment.<br /><br />Overall, this study suggests that vaginal CO2 AFLT may have some benefits for women with POP and vulvovaginal atrophy. However, further research is needed to understand its effectiveness in reorganizing histological structures and to determine its long-term effects.

Keywords

CO2 ablational fractional laser treatment

vaginal integument

pelvic organ prolapse

vaginal mesh repair

post-menopausal vulvovaginal atrophy

urinary tract symptoms

chronic vulvovaginitis

lamina propria

genitourinary syndrome of menopause

polypropylene mesh