Application of CO2-fraction laser photothermolysis in gynecological practice
It is useful for clinicians to be aware of the risks, limitations, and outcomes of laser therapy. This article analyzes the development of laser fractional thermolysis in medicine and substantiates its use in gynecology. Definitions of key terms for working on laser devices are pressented. The stages of the use of fractional lasers in dermatology are described, the features of the physics of a laser on living tissues are explained, and the choice of the type of laser and the options for selecting its parameters are analyzed in detail, with the rationale for choosing the parameters of a CO2-laser for various gynecological diseases. The mechanism of induction of tissue regeneration during fractional photothermolysis due to the effects of photobiomodulation has been substantiated. The indications and contraindications for CO2-fraction laser thermolysis in aesthetic gynecology and urogynecology with examples from systematic reviews and meta-analyses are described, and ready-to-use protocols for working on a CO2-laser platform are presented. The examinations necessary before CO2-fraction laser thermolysis of the vagina and vulva are discussed.Gorbunova E.A., Apolikhina I.A., Ramazanova M.O.
Conclusion: Many professionals are concerned about the lack of published full and operational laser parameters to enable the clinician to use lasers for a safe and effective outcome. This article describes the basics of the interaction of a CO2-fraction laser with tissue and shows how different parameters of laser fractional thermolysis can be applied to various conditions in gynecology and urogynecology.
Authors’ contributions: Gorbunova E.A. – article concept and design, collection, processing and analysis of the material, writing the text; Apolikhina I.A. – conception and editing of the article; Ramazanova M.O. – editing of the article.
Conflicts of interest: The authors declare no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Gorbunova E.A., Apolikhina I.A., Ramazanova M.O. Application of CO2-fraction laser photothermolysis in gynecological practice.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (7): 155-161 (in Russian)
https://dx.doi.org/10.18565/aig.2023.176
Keywords
fractional photothermolysis
fractional laser photothermolysis
laser fractional thermolysis
carbon dioxide laser
vulvovaginal laser therapy
vulvovaginal atrophy
genitourinary menopausal syndrome
CO2-fraction laser
stress urinary incontinence
vulvar lichen sclerosus
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Received 21.07.2023
Accepted 26.07.2023
About the Authors
Inna A. Apolikhina, MD, Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; Member of the Board of the Russian Society of Obstetricians and Gynecologists; President of the Association of Aesthetic Gynecology Specialists (AAGS), +7(495)735-10-55, i_apolikhina@oparina4.ru, https://orcid.org/0000-0002-4581-6295, 4, Akademika Oparina str., Moscow, Russia, 117997.Elena A. Gorbunova, Obstetrician-gynecologist, Researcher, Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)735-10-55, el_gorbunova@oparina4.ru, https://orcid.org/0000-0002-4723-4299, 4, Akademika Oparina str., Moscow, Russia, 117997.
Marina O. Ramazanova, Obstetrician-gynecologist, Postgraduate, Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)531-44-44, mar1naramazanova@yandex.ru, https://orcid.org/0000-0003-2508-7109, 4, Akademika Oparina str., Moscow, Russia, 117997.
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