Vaginal Fractional CO 2 Laser: A Minimally Invasive Option for Vaginal Rejuvenation

Introduction: To provide evidence that the use of a fractional CO 2 laser in combination with platelet-rich plasma (PRP) locally in the vagina mucous with minimal to moderate atrophy and pelvic floor exercise with perineometer would have effects of greater impact in the 3 layers of vaginal walls, including an important decrease of discomfort during sex. Materials and Methods: The study was composed of 2 groups: a study group and a control group. The main consultation purposes were vaginal dryness, dyspareunia, and local irritation. The study group underwent PRP, CO 2 laser, and pelvic exercise, whereas only PRP and pelvic exercise were applied to the control group. We used a special vaginal scanner, which was able to fractionize the laser and could be inserted in the vagina. Both groups were evaluated with a sexual questionnaire and vaginal biopsies. Results: An important improvement of vaginal mucous histology and a decrease of discomfort during sex were observed in most patients in the study group compared with the control group. Conclusion: Through the local use of vaginal fractional CO 2 laser, PRP, and pelvic floor exercises in women with symptoms of vaginal atrophy, beneficial effects are exerted in the 3 layers of the vagina rather than only the epithelium, as achieved with estrogens. We also observed a significant decrease of discomfort during sex. More data will be needed to better address the use of this new procedure.