J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://www.jcgo.org

Original Article

Volume 10, Number 1, March 2021, pages 11-17

Prospective Study of Fractional Carbon Dioxide Laser Therapy for Symptoms of Genitourinary Syndrome of Menopause: One-Year Follow-Up

Figure 1. Change in GSM assessment scores over time with pixelated CO₂ laser treatment. Lower scores indicate fewer or less severe symptoms for all assessments, except the BVHI.

**Table 1.** Baseline Characteristics of Subjects Undergoing Laser Treatment for GSM
Values presented are medians (25th, 75th percentiles), means ± standard deviation, or number (percent) of subjects, as appropriate. GSM: genitourinary syndrome of menopause.
Age (years)	58.3 ± 8.75
Parity	1 (1, 2)
Body mass index (kg/m²)	25.5 ± 3.39
Complained of stress urinary incontinence	1 (6.7)
Complained of urge urinary incontinence	3 (20.0)
History of breast cancer	6 (40.0)
Previous hysterectomy	5 (33.3)
Previously tried vaginal estrogen	5 (33.3)
Smoking status
Never	12 (80.0)
Former	3 (20.0)
Current	0 (0.0)
Pelvic organ prolapse
Stage 0	10 (66.7)
Stage 1	5 (33.3)

Table 1. Baseline Characteristics of Subjects Undergoing Laser Treatment for GSM

Values presented are medians (25th, 75th percentiles), means ± standard deviation, or number (percent) of subjects, as appropriate. GSM: genitourinary syndrome of menopause.

Age (years)

58.3 ± 8.75

Parity

1 (1, 2)

Body mass index (kg/m²)

25.5 ± 3.39

Complained of stress urinary incontinence

1 (6.7)

Complained of urge urinary incontinence

3 (20.0)

History of breast cancer

6 (40.0)

Previous hysterectomy

5 (33.3)

Previously tried vaginal estrogen

5 (33.3)

Smoking status

Never

12 (80.0)

Former

3 (20.0)

Current

0 (0.0)

Pelvic organ prolapse

Stage 0

10 (66.7)

Stage 1

5 (33.3)

**Table 2.** Short-Term Follow-Up Comparing GSM Assessments From Baseline to 2 Weeks After the Third Treatment Session
Assessment	Mean difference	95% Confidence interval	P value
GSM: genitourinary syndrome of menopause; BVHI: Bachmann Vaginal Health Index; VHA: Vaginal Health Assessment; VAS-VA: visual analog grading scale for vaginal atrophy symptoms; SAVQ: Symptoms of Atrophic Vaginitis Questionnaire; mVSQ: modified Vulvovaginal Symptom Questionnaire; PISQ-12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire; UDI-6: Urinary Distress Inventory.
BVHI	4.96	2.32, 7.60	0.002
VHA	-5.00	-6.78, -3.22	0.001
VAS-VA	-4.85	-6.61, -3.09	0.001
SAVQ	-5.48	-3.62, -7.34	0.001
mVSQ	-12.44	-16.33, -8.54	< 0.001
PISQ-12	-5.45	-8.16, -2.74	0.003
UDI-6	-7.64	-16.3, 1.02	0.070

Table 2. Short-Term Follow-Up Comparing GSM Assessments From Baseline to 2 Weeks After the Third Treatment Session

Assessment

Mean difference

95% Confidence interval

P value

GSM: genitourinary syndrome of menopause; BVHI: Bachmann Vaginal Health Index; VHA: Vaginal Health Assessment; VAS-VA: visual analog grading scale for vaginal atrophy symptoms; SAVQ: Symptoms of Atrophic Vaginitis Questionnaire; mVSQ: modified Vulvovaginal Symptom Questionnaire; PISQ-12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire; UDI-6: Urinary Distress Inventory.

BVHI

4.96

2.32, 7.60

0.002

VHA

-5.00

-6.78, -3.22

0.001

VAS-VA

-4.85

-6.61, -3.09

0.001

SAVQ

-5.48

-3.62, -7.34

0.001

mVSQ

-12.44

-16.33, -8.54

< 0.001

PISQ-12

-5.45

-8.16, -2.74

0.003

UDI-6

-7.64

-16.3, 1.02

0.070

**Table 3.** Comparison of Assessments of GSM From Baseline to 1 Year
Assessment	Mean difference	95% Confidence interval	P value
GSM: genitourinary syndrome of menopause; BVHI: Bachmann Vaginal Health Index; VHA: Vaginal Health Assessment; VAS-VA: visual analog grading scale for vaginal atrophy symptoms; SAVQ: Symptoms of Atrophic Vaginitis Questionnaire; mVSQ: modified Vulvovaginal Symptom Questionnaire; PISQ-12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire; UDI-6: Urinary Distress Inventory.
BVHI	4.55	0.66, 8.45	0.012
VHA	-5.21	-6.46, -3.97	< 0.001
VAS-VA	-5.46	-7.11, -3.81	0.001
SAVQ	-5.37	-7.62, -3.12	0.001
mVSQ	-12.80	-16.98, -8.62	< 0.001
PISQ-12	-7.11	-10.80, -3.42	0.002
UDI-6	-5.13	-14.83, 4.58	0.406

Table 3. Comparison of Assessments of GSM From Baseline to 1 Year

Assessment

Mean difference

95% Confidence interval

P value

BVHI

4.55

0.66, 8.45

0.012

VHA

-5.21

-6.46, -3.97

< 0.001

VAS-VA

-5.46

-7.11, -3.81

0.001

SAVQ

-5.37

-7.62, -3.12

0.001

mVSQ

-12.80

-16.98, -8.62

< 0.001

PISQ-12

-7.11

-10.80, -3.42

0.002

UDI-6

-5.13

-14.83, 4.58

0.406

**Table 4.** Comparison of Assessments of GSM Between Short-Term Follow-Up and 1Year Follow-Up
Assessment	Mean difference	95% Confidence interval	P value
GSM: genitourinary syndrome of menopause; BVHI: Bachmann Vaginal Health Index; VHA: Vaginal Health Assessment; VAS-VA: visual analog grading scale for vaginal atrophy symptoms; SAVQ: Symptoms of Atrophic Vaginitis Questionnaire; mVSQ: modified Vulvovaginal Symptom Questionnaire; PISQ-12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire; UDI-6: Urinary Distress Inventory.
BVHI	0.88	-1.80, 3.55	0.459
VHA	0.29	-1.60, 2.17	0.660
VAS-VA	-0.57	-1.38, 0.24	0.219
SAVQ	0.00	-0.89, 0.89	1.000
mVSQ	-1.21	-4.80, 2.38	0.336
PISQ-12	-0.49	-2.80, 1.83	0.914
UDI-6	3.27	-2.56, 9.10	0.121

Table 4. Comparison of Assessments of GSM Between Short-Term Follow-Up and 1Year Follow-Up

Assessment

Mean difference

95% Confidence interval

P value

BVHI

0.88

-1.80, 3.55

0.459

VHA

0.29

-1.60, 2.17

0.660

VAS-VA

-0.57

-1.38, 0.24

0.219

SAVQ

0.00

-0.89, 0.89

1.000

mVSQ

-1.21

-4.80, 2.38

0.336

PISQ-12

-0.49

-2.80, 1.83

0.914

UDI-6

3.27

-2.56, 9.10

0.121