Prospective Study of Fractional Carbon Dioxide Laser Therapy for Symptoms of Genitourinary Syndrome of Menopause: One-Year Follow-Up
Bibliographic record
Abstract
Background: Our objective is to prospectively evaluate pixelated carbon dioxide (CO 2 ) laser therapy for the treatment of symptomatic genitourinary syndrome of menopause (GSM) over 1 year using both subjective and objective assessment methods. Methods: Subjects with symptomatic GSM completed pre-treatment evaluations. Subjects underwent three standardized pixelated CO 2 laser treatments 4 weeks apart. Use of other treatments during the study period was prohibited. Subjects completed five subjective GSM questionnaires (visual analog grading scale for vaginal atrophy symptoms (VAS-VA), Symptoms of Atrophic Vaginitis Questionnaire (SAVQ), and a modified Vulvovaginal Symptom Questionnaire (mVSQ), Urinary Distress Inventory (UDI-6) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12)) and physical assessments (Bachmann Vaginal Health Index (BVHI) and Vaginal Health Assessment (VHA)) 2 weeks after each treatment, and at 1 year. Vaginal cytologic maturation assessment was performed before and after each treatment. Three random subjects also underwent vaginal biopsy after treatments were completed. A P value of less than 0.05 was considered statistically significant. Results: Fifteen subjects were recruited with an average age of 58.3 years (range 43 - 70). Subjects had significant improvements on four of the five subjective assessments of GSM and on the two objective indices, from baseline to shortly after the third treatment, and were maintained at 1-year follow-up, with no worsening of the improvements. Subjects did not have significant improvement in urinary symptoms. Histologically, the surface epithelium ranged from within normal limits to mild squamous atrophy. There was mild submucosal vascular congestion in all specimens, with evident neovascularization. Conclusions: Clinically significant improvement was noted in subjective and objective assessments of GSM, and was sustained for 1 year following pixelated CO 2 laser therapy. Histologic changes were consistent with mild submucosal neovascularization rather than estrogen-like epithelial squamous maturation. J Clin Gynecol Obstet. 2021;10(1):11-17 doi: https://doi.org/10.14740/jcgo729
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".