Authors: Alex Digesu
Publish Date: 2015/03/27
Volume: 26, Issue: 5, Pages: 785-785
Abstract
I would like to thank Dr Maggiore and colleagues for their input and remarks on our original editorial “Laser vaginal rejuvenation not ready for prime time” 1 2 as well as congratulate them on their work and contribution to a growing body of evidencebased techniques for managing important aspects of sexual dysfunction and vulvovaginal atrophy However I feel that their remarks reflect a misinterpretation and thus they are missing the major point of our editorialWhile I am in complete agreement that the widespread clinical application of the CO2 laser as a surgical tool in some areas of modern medicine is both significant and beneficial its other uses and advantages and disadvantages are beyond the scope of the original editorial We did not suggest that the CO2 laser did not have any clinical or surgical indication but merely that its application in the context of genital rejuvenation needs to be very cautiously appraised as currently there is a lack of a robust qualitative body of data on the therapeutic advantages of the CO2 laser The claim by Maggiore et al that laser vaginal rejuvenation is popular in that it improves certain aspects of appearance and sexual function according to our editorial has not yet been substantiated by a large enough body of evidenceTo this end it must be reiterated that there is an imminent and important need to build on the small case studies such as those reported by Maggiore et al in the form of a larger multicentred study While we accept and commend the efforts of Dr Maggiore and colleagues who have published several recent articles including the shortterm 12week followup and singlecentre pilot studies on the efficacy of CO2 laser therapy for vulvovaginal atrophy and dyspareunia to our knowledge their results for these conditions have not been reproduced by any other authors to date This is despite the fact that these treatments have been offered to women for over 10 yearsWe continue to feel strongly that there still remains a significantly underregulated and potentially dangerous practice of laser vaginal rejuvenation driven through potentially misleading marketing and a subsequent misguided uptick of this intervention whether through laser CO2 therapy or otherwise We feel that the therapeutic advantages of the CO2 laser in the context of vaginal rejuvenation can only be realistically upheld on the back of conclusive reproducible objective and wideranging reliable trials
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