Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham-controlled trial
Abstrakt
OBJECTIVE: To describe effects of non-ablative Er:YAG LASER on vaginal atrophy induced by iatrogenic menopause in the ewe. DESIGN: Animal experimental, randomised, sham and oestrogen-treatment controlled study with blinding for primary outcome.
SETTING: KU Leuven, Belgium. SAMPLE: Twenty-four ewes METHODS: Menopause was surgically induced, after which the ewes were randomised to three groups receiving either (1) vaginal Er:YAG LASER application three times, with a one-month interval; (2) three sham manipulations with a month interval; or (3) oestrogen replacement and sham manipulations.
At given intervals, ewes were clinically examined and vaginal wall biopsies taken. Vaginal compliance was determined by passive biomechanical testing from explants taken at obduction.
MAIN OUTCOME MEASURES: Vaginal epithelial thickness (primary), composition of the lamina propria (collagen, elastin, glycogen and vessels content), vaginal compliance, clinical signs. RESULTS: Animals exposed to Er:YAG LASER application and sham manipulation, but not to oestrogens, displayed a significant and comparable increase in vaginal epithelial thickness between baseline and seven days after the third application (69% and 67% respectively, both p<.0008).
In LASER treated ewes, temporary vaginal discharge and limited thermal injury were observed. Oestrogen substituted ewes displayed a more prominent increase in epithelial thickness (202%; p<.0001) and higher vaginal compliance (p <.05).
None of the interventions induced changes in the lamina propria. CONCLUSIONS: Vaginal Er:YAG LASER has comparable effect to sham manipulation in menopausal ewes.