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

• 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; Animal research; 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
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.16558

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