Histological Modifications of Postmenopausal Vaginal Mucosa After Repeated CO2 Laser
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 15
- 试验地点
- 2
- 主要终点
- Microscopic evaluation of number of papillae
研究概览
简要总结
To assess the long-term histological and clinical efficacy of MonaLisa Touch procedure for the management of the Genitourinary Syndrome of Menopause (GSM) in postmenopausal female patients.
详细描述
The investigator propose a prospective case series of 15 postmenopausal women with bothersome symptoms of GSM treated with MonaLisa Touch CO2 laser. The investigator hypothesize that even in the long term MonaLisa Touch will significantly improve GSM histologically and clinically from baseline.
The primary outcome objective of the study is to evaluate the histological modifications of the vaginal mucosa after repeated CO2 Monalisa Touch laser treatment. The investigator shall evaluate the role of this treatment by calculating the difference in vaginal epithelial thickness between the biopsy obtained before the start of laser treatment and the biopsy obtained after treatment. In addition, the study will analyze the safety of repeated laser treatments verifying the absence of fibrosis formation in the vaginal mucosa. Secondary objectives of the study will include an evaluation of the clinical effects associated with repeated Monalisa Touch CO2 laser treatments using validated questionnaires.
All participants will be screened to ensure inclusion/exclusion criteria are met. A biopsy will be taken from each patient one month before the first laser treatment and one month after the last laser treatment. The MonaLisa treatment will be performed monthly for 3 months. MonaLisa treatment with fractional microablative laser system. For subjects with concomitant vulvar symptoms, vulvar treatment will be done. Biopsy samples will be analyzed with Hematoxylin- Eosin and Trichrome staining, Periodic acid-Schiff (PAS) reaction for glycogen and immunohistochemistry for CD34, a vessel marker. All clinical questionnaires will be assessed at baseline and at one month after the last session.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Italian speaking and able to give informed consent.
- •Menopausal females with absence of menstruation for at least 12 months.
- •Presence of GSM symptoms.
- •Completion of at least two cycles of three laser treatments sessions in previous years.
- •Prolapse stage < II, according to the pelvic organ prolapse quantification (POP-Q) system.
- •No pelvic surgery within 6 months prior to treatment.
- •Understanding and acceptance to the obligation to return to all scheduled visits and follow-ups.
排除标准
- •Inability of give informed consent
- •History of vulvovaginal condyloma, vaginal intraepithelial neoplasia (VAIN), vaginal carcinoma, lichen sclerosis, lichen planus.
- •History of cancers of the lower genital tract (cervix, uterus, vagina).
- •History of pelvic radiotherapy.
- •Personal history of genital fistula, a thin recto-vaginal septum as determined by the investigator or personal history of a fourth degree laceration during screening physical exam.
- •Any other medical condition that the investigators feel would compromise the study.
- •Acute or recurrent urinary tract infection (UTI), or genital infection (e.g. bacterial vaginosis, herpes genitalis, candida).
- •Stage III or IV pelvic organ prolapse.
- •History of any female sexual disorder.
结局指标
主要结局
Microscopic evaluation of number of papillae
时间窗: 4-5 weeks after the last treatment
The number of papillae in bioptic samples will be analyzed with Hematoxylin- Eosin and Trichrome staining.
Microscopic evaluation for vaginal epithelial thickness
时间窗: 4-5 weeks after the last treatment
The vaginal epithelial thickness will be measured in micrometers. Then the difference in vaginal epithelial thickness between the biopsy obtained before and after the start of laser treatment will be calculated, considering a 20% increase as significant.
Microscopic evaluation of glycogen amount
时间窗: 4-5 weeks after the last treatment
The amount of glycogen present at the epithelial level and the ratio between the number of type I collagen fibers and type III will be evaluated with PAS reaction for glycogen.
Microscopic evaluation of number and size of the vessels
时间窗: 4-5 weeks after the last treatment
The number and size of the vessels present in the subepithelial layer will be evaluated using immunohistochemistry for CD34, a vessel marker.
次要结局
- Validated questionnaires LIKERT(4-5 weeks after the last treatment)
- Validated questionnaires ICIQ-UI(4-5 weeks after the last treatment)
- Validated questionnaires VHI(4-5 weeks after the last treatment)
- Validated questionnaires FSFI(4-5 weeks after the last treatment)
- Validated questionnaires UDI-6(4-5 weeks after the last treatment)