The use of neodymium laser in the treatment of vulval dystrophies

Abstract

Yu.E. Dobrokhotova1, A.Yu. Azimova1, E.I. Borovkova1, I.Yu. Il'ina1, D.M. Ibragimova1, I.I. Grishin1, E.S. Platova2, V.I. Komagorov1 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2N.I. Pirogov City Clinical Hospital No. 1, Moscow, Russian Federation Aim: to assess effectiveness of the Aerolase Neo neodymium laser with a 1064 nm wavelength and 650 ms pulse duration in the treatment of patients with chronic vulvar dystrophies. Patients and Methods: the study included 60 patients with lichen sclerosus and vulvar leukoplakia. Patients with the verified diagnosis of early-stage vulvar lichen sclerosus were randomly assigned to 2 groups. Group 1 consisted of 45 patients who were treated with the Aerolase Neo laser and group 2 consisted of 15 patients who applied topical clobetasol propionate 0.05% ointment over the vulvar area for 2 months: two times per day before the symptoms relieved and then — once per day, depending on the intensity of clinical manifestations, for 6 months. A comprehensive medical exam of patients was performed before and after treatment. Results: histological examination revealed that the group 1 patients had a brighter red staining of the stromal collagen fibers demonstrating a pronounced collagenization of the stroma after the treatment. In the group 2 patients the examination results did not demonstrate any significant changes. The number of complaints associated with vulvar dystrophies significantly decreased among the group 1 patients who received laser therapy, and they also reported a higher satisfaction with the quality of sexual life. Those patients who used topical glucocorticoids noted the recurred itching in the vulvar area which required the continuation of maintenance therapy for up to 6 months and suggested that glucocorticoids provided a short-term effect. Conclusion: the obtained results prove the effectiveness of neodymium laser therapy for patients with vulvar dystrophies thus providing a rationale for using this method of treatment. Keywords: lichen, leukoplakia, chronic vulvar dystrophies, neodymium laser, laser therapy, sexual life. For citation: Dobrokhotova Yu.E., Azimova A.Yu., Borovkova E.I. et al. The use of neodymium laser in the treatment of vulval dystrophies. Russian Journal of Woman and Child Health. 2023;6(2):138–144 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-138-144.