Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

Allison M. Quick, Andrew Hundley, Cynthia Evans, Julie A. Stephens, Bhuvaneswari Ramaswamy, Raquel E. Reinbolt, Anne M. Noonan, Jeffrey Bryan Van Deusen, Robert Wesolowski, Daniel G. Stover, Nicole Olivia Williams, Sagar D. Sardesai, Stephanie S. Faubion, Charles L. Loprinzi, Maryam B. Lustberg

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(1) Background: The objective of this study was to determine the long-term efficacy of fractional CO2 laser therapy in breast cancer survivors. (2) Methods: This was a single-arm study of breast cancer survivors. Participants received three treatments of fractional CO2 laser therapy and returned for a 4 week follow-up. Participants were contacted for follow-up at annual intervals. The Vaginal Assessment Scale (VAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scare Revised (FSDS-R), the Urinary Distress Inventory (UDI), and adverse events were collected and reported for the two-year follow-up. The changes in scores were compared between the four-week and two-year and the one-year and two-year follow-ups using paired t-tests. (3) Results: In total, 67 BC survivors were enrolled, 59 completed treatments and the four week follow-up, 39 participated in the one-year follow-up, and 33 participated in the two-year follow-up. After initial improvement in the VAS from baseline to the four week follow-up, there was no statistically significant difference in the VAS score (mean ∆ 0.23; 95% CI [−0.05, 0.51], p = 0.150) between the four week follow-up and the two-year follow-up. At the two-year follow-up, the FSFI and FSDS-R scores remained improved from baseline and there was no statistically significant change in the FSFI score (mean ∆ −0.83; 95% CI [−3.07, 2.38] p = 0.794) or the FSDS-R score (mean ∆ −2.85; 95% CI [−1.88, 7.59] p = 0.227) from the one to two-year follow-up. The UDI scores approached baseline at the two-year follow-up; however, the change between the one-and two-year follow-ups was not statistically significant (mean ∆ 4.76; 95% CI [−1.89, 11.41], p = 0.15). (4) Conclusions: Breast cancer survivors treated with fractional CO2 laser therapy have sustained improvement in sexual function two years after treatment completion, suggesting potential long-term benefit.

Original languageEnglish (US)
Article number774
JournalJournal of Clinical Medicine
Issue number3
StatePublished - Feb 1 2022


  • Breast cancer
  • Fractional CO laser therapy
  • Genitourinary syndrome of menopause
  • Vaginal atrophy

ASJC Scopus subject areas

  • General Medicine


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