| Abstract [eng] |
Aim of the study: to select and analyse publications regarding vaginal laser therapy in managing vulvovaginal atrophy after breast cancer treatment. Objectives: 1) To assess the efficacy of vaginal laser in managing vulvovaginal atrophy for patients treated for breast cancer; 2) To evaluate the safety of laser therapy to treat vulvovaginal atrophy in breast cancer survivors; 3) To conduct a metaanalysis and evaluate changes in severity of vaginal dryness and dyspareunia according to the Visual Analogue Scale as well as changes in score of the Vaginal Health Index and the Female Sexual Function Index before and after laser treatment in breast cancer survivors. Methods: a systematic literature review and metaanalysis was performed. PubMed, Scopus, ScienceDirect and Taylor&Francis databases were searched until December 2022. For statistical analysis, a random-effects model was used to pool mean differences with 95% confidence interval (CI). Results: a total of 13 studies (15 publications) with 502 breast cancer survivors were included in systematic literature review and 6 studies were included in metaanalysis. The analysed studies show a statistically significant decrease in vaginal dryness, pruritus, dyspareunia and dysuria, a decrease in the level of vaginal atrophy, and an improvement in sexual function after completed laser treatment in breast cancer survivors. One month after completing laser treatment, vaginal dryness decreases by 4.95 points (95% CI -6.41 – -3.49; p<0.00001), dyspareunia by 4.82 (95% CI -7.34 – -2.29; p<0.00001) according to the Visual Analogue Scale, sexual function improves by 7.55 points (95% CI 5.32 – 9.79; p<0.00001) according to the Female Sexual Function Index, and vaginal health improves by 8.62 points (95% CI 5.54 – 11.71; p<0.00001) according to the Vaginal Health Index. No major adverse events were reported. Conclusions: 1) Laser therapy could be effective in alleviating vaginal dryness, pruritus, dyspareunia and dysuria, as well as reducing vaginal atrophy and improving sexual function in women after breast cancer treatment, and the positive effect lasts for at least two years; 2) Vaginal laser is considered a safe method to treat vulvovaginal atrophy without severe short-term and long-term complications; 3) One month after completing laser treatment, vaginal dryness and dyspareunia as assessed by the Visual Analogue Scale decreases by 4.95 and 4,82, respectively, sexual function improves by 7.55 points according to the Female Sexual Function Index, and vaginal health improves by 8.62 points according to the Vaginal Health Index. |
