What is LASER?
L =
A =
S =
E =
R =
Light
Amplification
Stimulated
Emission
Radiation
What does a LASER device actually do?
A laser device produces an intense, narrow beam of light (or other radiation). Lasers have broad applications, being used in engineering, the music industry and medicine.
[L]ight [A]mplification by the [S]timulated [E]mission of [R]adiation.
Types of Laser
- Gas
- Chemical
- Dye
- Metal-vapour
- Solid-state
- Semiconductor
- Others
Non surgical laser vaginal rejuvenation
- Petit Lady Action 11
- MonaLisa Touch
Surgical laser vaginal rejuvenation
- Fox
Features of Lasers used for Vulvo-Vaginal Treatment
Petit Lady Action 11:
- A solid-state laser
- Erbium YAG (Er:YAG)
- Wavelength – 2.9 micrometre
- Commonly used in skin resurfacing
- Non-ablative
- Allows controlled heating without burning vaginal epithelium
- Promotes Collagen fibre shrinkage and remodelling
MonaLisa Touch:
- A gas laser
- Carbon dioxide (CO2)
- Wavelength – 10.6 micrometre
- Ablative with tissue denaturation
- Promotes collagen and elastin fibre remodelling
Fox Diode laser:
- Semiconductor laser
- Wavelength – 0.2 – 20 micrometre
- The short wavelength makes it an excellent dissection/cutting tool
What is Laser Vaginal Treatment?
This can be defined as the application of a laser to treat the vaginal walls, introital area or vulva
Non-surgical laser vaginal treatment involves a pulsed or fractionated beam
Surgery with a laser uses the energy as a dissecting and cutting tool
This is an office procedure
Day surgery or overnight stay
Action II Petit Lady Erbium YAG Laser System
Petit Lady treatment with Action II is a non-surgical, non-invasive treatment for vaginal rejuvenation
How does the laser work?
The Action II is a 2940 nm Er:YAG laser system, with excellent absorption in water. As the vaginal mucosa has a high water content, this makes it an ideal and safe target for this laser wavelength. Collagen remodelling of the vaginal mucosa tissue is encouraged by the photothermal effect of the laser, which promotes thickening of the walls of the vaginal canal through collagen regeneration.
Dual Mode (Dual pass technique)
Dual Mode enables a deeper secondary thermal effect, and it controls heating of the delicate target tissues of the vaginal wall. The design of the intravaginal scopes makes the procedure more convenient and time-efficient.
Features of the Petit Lady Action II
Treatments
- Reduction of vaginal wall atrophy
- Vaginal tightening
- Vulval tightening and resurfacing
- Mons pubis tightening and resurfacing
- Sexual gratification improvement
- Reduction of vulval epithelial relaxation
- Reduction &/or improvement of the appearance and texture of scars
- Improves the appearance of pigmented vulva
- Mild stress urinary incontinence
- The Action II Petit Lady has a 90° hand piece that directs the laser at a right angle for treatment of the suburethral tissues, thereby improving support. It can also be used to treat the forchette and the junction of the labia minora and introitus.
- A fractional hand piece is used for treatment of the labia minora, labia majora, mons pubis and scars such as those from a Caesarean section.
- A 360° hand piece directs the laser beam circumferentially through the vaginal wall epithelium
This treatment, in carefully selected women, can lead to improvements in sexual function, quality of life and self-esteem.
Treatment of vaginal atrophy
Tighter vagina and vestibule
Reducing stress urinary incontinence
A set of aggravating symptoms related to vaginal atrophy generally become worse over time. Symptoms include vaginal dryness, burning sensation, vaginal discharge, genital itching, burning with urination, and reduced vaginal lubrication during sexual activity.
For those who suffer from vaginal atrophy, the decreased oestrogen levels cause thinning, drying and inflammation of the vaginal wall. One myth about vaginal atrophy is that the condition happens most frequently after the menopause, but it can actually occur during breast-feeding or at any time when the oestrogen levels drop and the onset is frequently noted during the perimenopause.
Sexual gratification may be significantly influenced by the degree of vaginal tightness in some women.
Vaginal Rejuvenation aims to make the vestibule and vaginal canal narrower and, thus, increase the amount of friction produced during intercourse.
This may improve sensation and enhance sexual satisfaction.
Stress Urinary Incontinence (SUI) is defined as unintentional or uncontrollable leakage of urine due to the weakened tissues supporting the urethra. The tissues supporting the pelvic floor and the urethra (in particular the suburethral area and the bladder base) may be strengthened by laser treatment.
Non-surgical laser treatment is highly unlikely to cure moderate or severe stress urinary incontinence.
Overcome post-delivery vaginal alterations
Improve the appearance of the vulva
Pregnancy, labor and vaginal delivery are significant events in the development of symptoms of decreased sensation and deterioration in vaginal tissues. All three events negatively impact the tightness, tone, control, and strength of the vagina. Non surgical Laser Vaginal Rejuvenation, can restore tightness and elasticity of the vagina.
The fractionated laser setting can help restore the natural colour and texture of the vulva by improving collagen formation, tightening the skin and reducing hyperpigmentation.
Risks of Laser Treatment
Unintended thermal injury
Specifically:
Eye protection
The laser delivers energy in the form of heat and this is how it stimulates the production of collagen (see previous notes). Either too much energy is delivered to the area intended for treatment or energy is delivered to an area not intended for treatment.
Thermal injury which is not therapeutic is one that results in a burn on the surface of the vaginal epithelium. Such events are uncommon and usually resolve spontaneously. Rarely, a burn is more significant and requires medical or surgical intervention.
Whenever a laser is used in any field (medicine/surgery/engineering/industry etc), people in the environment of the laser must where suitable laser glasses. Looking directly into an active laser beam can result in permanent visual injury.
FDA warning 2018
Practical response to FDA warning:
- The advisory has not removed energy-based devices from the market.
- Energy device companies are counselled to cease marketing such products in a deceptive manner; in other words not to make claims that are not supported by available evidence about the potential benefits of treatment.
Medical practitioners should be trained in the use of the device that they are using on their patients in the area of the body in which they intend to apply it.
Patients intending to undergo treatment with an energy device in any part of their body should ask their doctor about the device intended to be used, the potential risks and benefits of treatment as well as the doctors experience using the device.
Frequently Asked Questions
How long does the treatment take?
How many treatments will I need?
How long is the downtime?
The approximate treatment time is 15 minutes per area treated.
The recommended number of sessions is 3. The interval between sessions is 2 weeks. Repeat treatments may be beneficial every 6 months.
Normal activities of daily living can be resumed immediately. Sexual intercourse should be deferred for 1-2 days.
Is this done in the office or hospital?
How effective is the treatment?
Is there a Medicare rebate for the treatment?
This is an office treatment that does not require admission to hospital.
- Current evidence in the published literature is limited, but indications for use include vaginal atrophy, reduction of vaginal wall relaxation, increasing the apparent tightness of the vagina and treating very mild stress incontinence. The fractionated setting for vulval treatment produces excellent resurfacing.
There is no Medicare rebate for the treatment.
Is there any pain associated with the treatment?
Can treatment take place at any time of the menstrual cycle?
How does Healite II work?
The treatment is painless for the majority of patients.
The treatment cannot take place during menstruation.
A photothermal effect and gentle ablation stimulates collagen remodelling.
