Clinical Efficiency Of Dot CO₂ Laser Therapy For Vulvar Lichen Sclerosus

Objective:The aim of this study was 1.To further summarize Clinical features of VLS;2.To analyze the correlation between the degree of lesions and the course of the disease;3.Analysis of clinical efficacy of dot-matrix laser therapy on VLS;4.Analysis of the overall therapeutic effectMethods:This study was retrospectively collected and analyzed the clinical data of 40 patients with VLS in gynecological outpatient clinics of the Obstetrics and Gynecology Hospital of Dalian Medical University from May 2018 to April 2019.All the patients were confirmed by biopsy and pathological examination This study was approved by the ethics committee of the Maternity and Child Health(Gynecology and Obstetrics)Hospital of Dalian Medical University,and informed consent was signed from the patientsResults:The 40 patients,age ranged from 26 to 73 years,with an average age of(50±14.6)years.23/40(57.5%)of the patients were Menopausal;17/40(42.5%)were non-menopausal,among the non-menopausal 9/17(53%)patients age>35 years old,8/17(47%)patients age<35 years.Among the 40 patients,the course of the disease was 0.5 to 20 years,and the average course was(7.6 ± 6.4)years.Clinical symptoms positively correlated with the duration of the disease,the longer the duration of the disease,the greater the intensity of itching and dyspareunia.There was no or weak correlation between the severity of skin elasticity and skin color lesions and the duration of the disease(P>,0.05).There was a correlation between the extent of the skin lesion area and the duration of the disease(P<0.05).The longer the course of the disease,the larger the skin lesion area.Vaginal itching and vulvar pain at one month after the first treatment and one month after the third treatment,and 3,6,12 months of follow up after the last treatment were statistically significant after comparing with before treatment(P<0.001).There was no statistical significance after comparing dyspareunia at one month after the first treatment and before treatment(P>0.05);at one month after the third treatment,3,6,12 months of follow up after the last treatment and before treatment were all statistically significant(P<0.001).There was no significant difference in skin morphology between 1 month after the first treatment and one month after the third treatment and 3 and 6 months of follow up after the last treatment(P>,0.05).At 12 months of follow up after the last treatment compared with before treatment was statistically significant(P<0.05).The total efficiency was 100%,and the overall satisfaction was 95.0%.There were no serious complicationsConclusion:VLS can occur in women of any age and is more common in postmenopausal women.The etiology of VLS may be related to autoimmune diseases and hormonal changes.The clinical symptoms of VLS positively correlated with the course and duration of the disease.The clinical signs of skin elasticity and skin color had no or weak correlation with the duration of the disease,while the extent skin lesion area correlated with the duration of the disease.There was a significant improvement in vulva pruritus and vulvar pain at one month after the first treatment compared with before treatment.Dyspareunia,skin color and skin lesion area improved significantly one month after the third treatment.Skin morphology improved at six months of follow up after the last treatment.The total efficiency was 100%,and the overall satisfaction was 95.0%There were no serious complications.