Unyango lwe-laser lwe-CO2 olusebenzisa i-fractional microblative lufunyenwe lusebenza kwaye lukhuselekile ekunyangeni i-vulvovaginal atrophy okwethutyana, ngokutsho kophando olukwijenali i-Menopause.
Uphononongo lwetshathi yokujonga emva lwaluquka abafazi abali-139 abaneempawu ze-vulvovaginal atrophy, abagqibe iiseshoni ezintathu ze-laser malunga neeveki ezi-6 ezahlukeneyo kwikliniki yeVulvar kunye neSexual Health eProhealth, eWaukesha Memorial Hospital, eWisconsin, ukususela ngoJanuwari 2016 ukuya kuDisemba 2019.
Zonke izigulana bezingaphezulu kweminyaka eli-18 ubudala (ubudala obuphakathi kweminyaka engama-62) kwaye azikhulelwanga.
I-estrogen ehambelanayo ekwindawo ethile ixelwe kwi-53% yezigulane (n = 74). Ukuxilongwa komhlaza webele kubhalwe kwi-27% (n = 38) kunye ne-lichen sclerosus kwi-22% (n = 31).
Izigulana zihlolwe ngaphambi konyango lokuqala nolwesithathu nge-laser ngokusebenzisa imibuzo emibini eqinisekisiweyo: i-Female Sexual Function Index (FSFI) kunye ne-Vulvovaginal Symptoms Questionnaire (VSQ). Kuzalisiwe ne-visual analog scale (VAS).
Unyango luqale lwenziwa ngendlela yesini kusetyenziswa iprobe yesini kwaza kwalandela unyango lwe-vulvar olwenziwe ngesixhobo esahlukileyo sesandla, kusetyenziswa ipateni yesikwere. I-Lidocaine 2% yafakwa kwizicubu zesini imizuzu engama-20 ngaphambi konyango. Useto lwe-laser lonyango lwesini nesini lufana nolwezifundo zangaphambili.
Ulandelelwano oluphakathi beluyiiveki ezili-13.8.
Onke amanqaku e-FSFI aphucukile: unyango lwangaphambi konyango 12.7 xa kuthelekiswa nonyango lwasemva konyango 19.0 (P)
I-VSQ ikwabonise ukuba imibuzo eli-18 kwengama-21 iphucuke kakhulu (P
Ukongeza, i-VAS ibonakalise ukuphucuka okukhulu kwintlungu yokwabelana ngesondo kunye nokoma kwesitho sangasese sowesifazane: unyango lwangaphambi kwe-12.7 kunye ne-4.6, ngokulandelelana xa kuthelekiswa nonyango lwasemva kwe-2.4 kunye ne-1.5 (zombini i-P
Ngaphezu koko, abanye abafazi abali-17 baqalise ukuzibandakanya ngokwesondo emva konyango lwesibini lwe-laser. Akukho ziganeko zimbi zibikwe phakathi kwabo bathathe inxaxheba kolu phando.
“Samangaliswa kukuba izigulana ziphucuke kwangoko emva konyango olunye okanye ezimbini,” utshilo umphandi oyintloko uSarit Aschkenazi MD, MS, umlawuli wezonyango kwiProhealth Waukesha Memorial Hospital. “Inkqubela iyenzekile nakubafazi abaneempawu ezinzima abangaphenduliyo kunyango oluqhelekileyo, olufana ne-estrogen engaphandle, okanye abo basebenzisa i-aromatase inhibitors yokuthintela umhlaza webele. Savuya kakhulu ukubona abafazi abane-lichen sclerosis abane-skin atrophy ephucukileyo bebonisa iimpawu zokuphucuka.”
Unyango lwelaser lucingelwa ukuba lusebenza ngokuhambisa amandla kwizicubu ezingaphantsi komhlaba, ngomonakalo omncinci kwi-epithelium ephezu kwayo. Luvuselela ii-fibroblasts ukuba zivelise iifayibha ze-collagen kunye ne-elastin ezingaphezulu, kunye nokwandisa umthamo wamanzi, ukugoba kwesikhumba, kunye nobukhulu be-epithelial yesikhumba se-vaginal kunye ne-vulvar, ngokutsho kuka-Aschkenazi.
“Oku kufana nemiphumo eveliswa xa i-laser isetyenziswa eluswini lobuso,” utshilo. “I-laser isetyenzisiwe eluswini lobuso kangangeminyaka engaphezu kweshumi kwaye kubhalwe ukuba ikhuselekile. Iibhayopsy zesikhumba zibonakalise ezi ziphumo. Zonke ezi nguqu ziyafana notshintsho olwenzeka xa i-estrogen ikhona kwizicubu kumanqanaba angaphambi kokuya exesheni.”
I-laser ibonakala ilunyango oluthembisayo olunokusetyenziswa kwimeko eqhelekileyo efana ne-vulvovaginal atrophy. “Olu lukhetho olutsha xa i-estrogen ingasebenzi, ingavumelekanga okanye ingafuneki,” utshilo u-Aschkenazi.
Nangona kunjalo, kufuneka izifundo zolawulo ezingacwangciswanga ukuze kuqinisekiswe ngokucacileyo ukusebenza kakuhle konyango lwelaser, kunye nokumisela inani elifanelekileyo leeseshoni zonyango, amaxesha athile kunye nokuba i-booster iphindwe kangaphi.
“Olunye unyango olunokuvavanywa kukudibanisa unyango lwelaser nonyango lwehomoni olusetyenziswa ngelaphu, xa lungathintelwanga, njengonyango lwe-estrogen okanye i-topical dehydroepiandrosterone (DHEA) ukuze kwandiswe ukuphuculwa kwezicubu kunye nokufezekisa isiphumo sokusebenzisana ngeedosi ezisezantsi,” utshilo u-Aschkenazi.
Nangona i-laser ifunyenwe ikhuselekile kuzo zonke izigulana ezifundwayo, u-Aschkenazi ucebisa ukusebenzisa iindlela zonyango eziqhelekileyo kwiimpawu ze-vulvovaginal atrophy kuqala ngaphambi kokongeza unyango lwe-laser, kunye nokulandela iindlela zonyango ukuze kuthintelwe naziphi na iziphumo ezimbi. Abo banengxaki yeempawu ezinjalo kufuneka bagcine ukhathalelo lolusu ngokunciphisa izinto ezibangela ukucaphuka kolusu, iimpahla zangaphantsi eziqinileyo, isepha kunye nee-pads zabasetyhini ezinevumba elimnandi. "Ukongeza ii-moisturizers ezingezizo iihomoni kunceda ukunqanda ukoma okunxulunyaniswa neempawu zokuya exesheni," utshilo.
Unyango lwe-laser lwe-CO2 oluqhekeziweyo kwi-vulvovaginal atrophy Ividiyo enxulumene nalo:
"Isiqalo somgangatho, Ukunyaniseka njengesiseko, Inkxaso enyanisekileyo kunye nenzuzo efanayo" yingcamango yethu, ukuze sakhe ngokuphindaphindiweyo kwaye silandele ukugqwesa Ukususa iinwele ngobuninzi , Umatshini we-Ipl wezonyango , I-Laser enamandla aphezulu , Iimveliso zethu zithunyelwe kumazwe angaphandle kakhulu kumzantsi-mpuma we-Asia Euro-America, kwaye zithengiswa kulo lonke ilizwe lethu. Kwaye ngokuxhomekeke kumgangatho ogqwesileyo, ixabiso elifanelekileyo, inkonzo engcono, sifumene impendulo entle evela kubathengi baphesheya. Wamkelekile ukuba ujoyine nathi ukuze ufumane amathuba kunye neenzuzo ezingaphezulu. Siyamkela abathengi, imibutho yoshishino kunye nabahlobo abavela kuzo zonke iindawo zehlabathi ukuba banxibelelane nathi kwaye bafune intsebenziswano ukuze bafumane iingenelo ezifanayo.