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Vaginal Laser Therapy in Breast Cancer Survivors

Not Applicable
Conditions
Dyspareunia
Vaginal Atrophy
Breast Cancer
Genitourinary Syndrome of Menopause
Interventions
Device: Microablative Fractional CO2 Laser Therapy
Registration Number
NCT03738605
Lead Sponsor
National and Kapodistrian University of Athens
Brief Summary

This study evaluates the efficacy of vaginal CO2 laser therapy in breast cancer survivors with symptoms of Genitourinary Syndrome of Menopause. Half of participants will receive active laser therapy, while the other half placebo therapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
50
Inclusion Criteria
  • breast cancer history
  • dyspareunia
  • dryness
Exclusion Criteria
  • Active genital infection (i.e herpes, vaginitis)
  • Prolapse stage >=2
  • Underlying pathologies that could interfere with the protocol compliance

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Laser GroupMicroablative Fractional CO2 Laser TherapyMicroablative Fractional CO2 Laser Therapy (The parameters that will be used are the following: 1) Power: 30 ή 40 watts, 2) Dwell time:1000μs, 3) Spacing 1000 μm, 4) Depth: SmartStak parameter from 1-3 depending on the treatment status, 5) D-pulse mode.)
PlaceboMicroablative Fractional CO2 Laser TherapyPlacebo therapy (The parameters that will be used are the following: 1) Power: 0.5 watts, 2) Dwell time:1000μs, 3) Spacing 1000 μm, 4) Depth: SmartStak parameter 1, 5) Smart-pulse mode.
Primary Outcome Measures
NameTimeMethod
10-centimeter Visual Analogue Scale assessing intensity of dyspareunia and drynessChange from baseline at 1 month post-treatment

It is a straight line with 2 endpoints "0" and "10". Zero defines "no dyspareunia at all" and "no dryness at all" , while 10 "dyspareunia as bad as it could be" and "dryness as bad as it could be". Participants will draw a line at or between the 2 end points. The distance between zero and drawn line will define the intensity of dyspareunia and dryness

Secondary Outcome Measures
NameTimeMethod
International Consultation on Incontinence Questionnaire Short Form6 months

it is a questionnaire with 4 questions assessing the amount of leakage, frequency and type of urinary incontinence. Total score is calculated by summing the 3 out of the 4 questions. Higher scores indicate worst urinary incontinence

Urogenital Distress Inventory 66 months

It is a condition specific questionnaire containing 6 questions. The answers of questions assesses the presence of symptoms and the degree of bother on a 4-point scale ("not at all", "a little bit", "moderately" and "greatly" applying to 0, 1, 2 and 3, respectively). Total score is calculated by summing the score of each question. The higher the total score the highest is the symptom bother

Vaginal Health Index Score6 months

It evaluates vaginal elasticity, fluid volume, ph of vaginal fluid, epithelial integrity and moisture. Each one of these may receive scores from 1 to 5. Total score is calculated by summing the 5 scores ranging from 5 to 25. Higher scores indicate better vaginal status.

Modified Sexual Quality of Life Questionnaire-Male6 months

It includes 12 questions assessing the quality of life and sexual satisfaction of the male partner. Each answer may receive values from 1 to 5. The higher the scores the better subjective evaluation of sexual quality of life

Patients Global Impression of ImprovementAt 1-month post-treatment

It is a single item questionnaire assessing the impression of participants following the intervention

10-centimeter Visual Analogue Scale assessing intensity of itching, burning and dysuriaChange from baseline at 1 month post-treatment

It is a straight line with 2 endpoints "0" and "10". Zero defines "no symptom (itching, burning and dysuria) at all" , while 10 "symptom (itching, burning and dysuria) as bad as it could be". Participants will draw a line at or between the 2 end points. The distance between zero and drawn line will define the intensity of itching, burning and dysuria

King's Health Questionnaire (KHQ)Change from baseline at 1 month post-treatment

It has 3 sections: 1) general health and overall health related to urinary symptoms with 2 questions, 2) incontinence impact, role limitations, physical limitations, social limitations, personal limitations, emotions, sleep and energy, and severity coping measures with 19 questions and 3) bother or impact of urinary symptoms with 11 questions. Scores of each domain of the 2 sections range from 0 to 100. Scores of the third section range from 0 to 3. Higher scores indicate higher impact of urinary incontinence.

3 days voiding diaryChange from baseline at 1 month post-treatment

Assesses frequency of urination, amount of urine, presence of urgency and/or urinary incontinence and amount of fluid intake

Female Sexual Function IndexChange from baseline at 1 month post-treatment

It is a questionnaire defining women's sexual function. It includes 6 domains: desire, arousal, orgasm, lubrication, satisfaction and pain. The answer of each Question in each domain are multiplied by a certain factor. Total score is calculated by summing the scores of the all domains with a minimum value of 2 and a maximum of 36. The highest the total score the better is the sexual functioning. Total score above 26.55 defines normal sexual function

Epithelial thickness6 months

Biopsies will be obtained from the lateral vaginal wall. Epithelial thickness (in μ) will be measured by a vertical line between basal layer cells and superficial layers.

Collagen6 months

Biopsies will be obtained from the lateral vaginal wall. Determination of collagen types using immunohistochemistry and microscopy.

Day-to Day Impact of vaginal aging questionnaire (DIVA)Change from baseline at 1 month post-treatment

It includes 4 domains: activities of daily living (5 items), sexual functioning (5 items), emotional well-being (4 items), self-concept and body image (5-items). Each item of each domain could receive values from 0 to 4. Mean scores are calculated on each of the domain scales. Higher scores indicate greater symptom impact

Vaginal Maturation Value6 months

It is calculated by defining the percentage of superficial, intermediate and parabasal epithelial cells on the vaginal pap smear, following the formula (1x%superficial)+(0.5x%intermediate)+(0x%parabasal). It may receive values from 0 to 100%.It is considered to be an indicator of the estrogenic stimulation, whereas values of 0-49%, 50-64% and 65-100% indicate absent/low, moderate and high estrogenic effect on the vaginal epithelium, respectively.

Number of blood vessels6 months

Biopsies will be obtained from the lateral vaginal wall. Computerized determination of blood vessels number will be performed

Size of blood vessels6 months

Biopsies will be obtained from the lateral vaginal wall. Computerized determination of the blood vessels size will be performed

Trial Locations

Locations (1)

Urogynecological Unit of Alexandra Hospital

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Athens, Greece

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