Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham‐controlled trial

Objective To describe effects of non‐ablative erbium‐doped:yttrium‐aluminium‐garnet (Er:YAG) laser on vaginal atrophy induced by iatrogenic menopause in the ewe. Design Animal experimental, randomised, sham and estrogen‐treatment controlled study with blinding for primary outcome. Setting KU Leuven,...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2021-05, Vol.128 (6), p.1087-1096
Main Authors: Mackova, K, Mazzer, AM, Mori Da Cunha, MGMC, Hajkova Hympanova, L, Urbankova, I, Kastelein, AW, Vodegel, E, Vander Linden, K, Fehervary, H, Guler, Z, Roovers, JP, Krofta, L, Verhaeghe, J, Deprest, J
Format: Article
Language:English
Subjects:
Aluminum
Animals
Atrophy
Atrophy - diagnosis
Atrophy - drug therapy
Atrophy - etiology
Atrophy - radiotherapy
Biopsy - methods
Collagen
Disease Models, Animal
Elastin
epithelium
estrogen
Estrogen receptors
Estrogen Replacement Therapy - methods
Estrogens
Estrogens - pharmacology
Explants
Female
Glycogen
Hormone replacement therapy
Lamina propria
laser
Lasers
Lasers, Solid-State - therapeutic use
Low-Level Light Therapy - adverse effects
Low-Level Light Therapy - methods
Menopause
planar biaxial testing
Sheep
Thermal injury
Treatment Outcome
Vagina
Vagina - pathology
Vaginal Diseases - drug therapy
Vaginal Diseases - pathology
Vaginal Diseases - radiotherapy
Yttrium
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Summary:Objective To describe effects of non‐ablative erbium‐doped:yttrium‐aluminium‐garnet (Er:YAG) laser on vaginal atrophy induced by iatrogenic menopause in the ewe. Design Animal experimental, randomised, sham and estrogen‐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 vaginal Er:YAG laser application three times, with a 1‐month interval; three sham manipulations with a 1‐month interval; or estrogen replacement and sham manipulations. At given intervals, ewes were clinically examined and vaginal wall biopsies were taken. Vaginal compliance was determined by passive biomechanical testing from explants taken at autopsy. Main outcome measures Vaginal epithelial thickness (primary), composition of the lamina propria (collagen, elastin, glycogen and vessel content), vaginal compliance, clinical signs. Results Animals exposed to Er:YAG laser application and sham manipulation, but not to estrogens, displayed a significant and comparable increase in vaginal epithelial thickness between baseline and 7 days after the third application (69% and 67%, respectively, both P 
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.16558