Fractional CO2 laser safe, effective in vestibular pain

Treatment with fractional CO₂ laser is both safe and effective for women suffering from vestibular pain, as shown in a recent study.

Seventy women who met the eligibility criteria were randomly assigned 2:1 to receive active or sham (zero energy) fractional CO₂ laser therapy using the vestibular probe. Patients in each group received three treatments spaced 4 weeks apart.

At the initial follow-up on week 12, the investigators unblinded the participants and assigned those initially receiving sham to the active treatment.

Following treatment with fractional CO₂ laser, significant improvements were observed in five parameters of the Vulvoscopic Genital Tissue Appearance Scale. Pain associated with cotton-tipped swab testing significantly decreased at weeks 4 through 16 (mean change from baseline, ‒0.64, 95 percent confidence interval [CI], ‒0.79 to ‒0.50 and ‒1.31, 95 percent CI, ‒1.46 to ‒1.16, respectively).

Female Sexual Function Index (FSFI) pain domain scores saw significant improvements at weeks 12 and 16 (mean change from baseline, 0.925, 95 percent CI, 0.10‒1.75 and 1.22, 95 percent CI, 0.40‒2.05, respectively). FSFI total scores markedly increased during the same period (mean change from baseline, 6.24, 95 percent CI, 2.64‒9.85 and 4.96, 95 percent CI, 1.36‒8.57, respectively).

At weeks 12 and 16, Female Sexual Distress Scale–Revised scores significantly reduced (mean change from baseline, ‒5.84, 95 percent CI, ‒8.80 to ‒2.87 and ‒9.15, 95 percent CI, ‒12.11 to ‒6.18, respectively), as did the Interstitial Cystitis Symptom Index (mean change from baseline, ‒0.91, 95 percent CI, ‒1.65 to ‒0.18 and ‒0.754, 95 percent CI, ‒1.49 to ‒0.02, respectively).

At week 16, Interstitial Cystitis Problem Index scores substantially decreased as well (mean change from baseline, ‒0.99, 95 percent CI, ‒1.63 to ‒0.34). On the other hand, no significant changes occurred in the sham arm. In addition, no serious adverse events were reported.

“Fractional CO₂ laser treatment in women with vestibular pain resulted in improvement from baseline in multiple key outcome measures of vestibular health,” the investigators said.