CAN LASER ALLEVIATE THE MANIFESTATIONS OF SJOGREN’S SYNDROME IN GYNECOLOGY – PILOT STUDY PRELIMINARY DATA
2Clinic for Nephrology and Clinical Immunology, Faculty of Medicine, University of Novi Sad, Novi Sad
3/, Faculty of Medicine, University of Novi Sad, Novi Sad
4Gynecology, Laser and Health Academy, Ljubljana
Problem statement
Women suffering of Sjogren’s Syndrome (SS) often complain of the gynecological manifestations of SS, mostly the vaginal dryness and dyspareunia. The presence of SS significantly aggravates the symptoms of genitourinary syndrome of menopause (GSM). In the last decade, the laser therapies for GSM become popular minimally invasive approach for GSM treatment, thus we decided to assess the efficacy and safety of a therapy with non-ablative ErYAG laser on patients with gynecological manifestations of SS.
Methods
Patients recruited from the University department for nephrology and immunology and diagnosed with SS by two immunologists on the bases of their clinical and immunological results, complaining of gynecological manifestations of SS, were included in this study. Before the laser therapy multiple assessment tools were applied to the patients: FSFI, DLQI, VHIS, EULAR SS disease activity index (ESSDAI), gynecological exam, swab and biopsy samples were also taken. Patients were treated with three sessions of non-ablative ErYAG laser with one-month intervals. Before the second and third sessions FSFI, DLQI, VHIS and infection screening were performed. Follow-ups were scheduled at 1, 3 and 6 months after the last laser session. At each follow-up, the measurements of multiple features using above mentioned tools were repeated and the results compared with the baseline. Potential adverse effects and patients’ satisfaction were also observed at each visit.
Results
So far 8 patients were recruited in this study, 4 of them already completed the laser treatment. All patients improved in all observed characteristics. FSFI score improved from 13.7 to 27.5; VHIS from 13.5 to 20.3; DLQI decreased from 10.5 to 0.7; patients’ assessment of dryness improvement was 35% and satisfaction with results 7/10. No adverse effects were reported.
This study is ongoing, and more patients will be included.
Conclusion
Preliminary results of Erbium laser treatment of small number of SS patients with gynecological manifestations showed efficacy in improvement of observed symptoms without adverse effects noted. Patients tolerated the treatment well and their satisfaction was high. More patients and longer follow-up are needed to get a good assessment of efficacy and safety of this treatment for SS patients with gynecological complaints.