Ukwelashwa nge-laser ye-CO2 microblative okuyingxenye kutholakale kusebenza kahle futhi kuphephile ekwelapheni i-vulvovaginal atrophy yesikhashana, ngokusho kocwaningo olukumagazini i-Menopause.
Ukubuyekezwa kweshadi lokubheka emuva kwakuhlanganisa abesifazane abangu-139 abanezimpawu zokuphelelwa amandla kwe-vulvovaginal, abaqede izikhathi ezintathu ze-laser eziqhelelene cishe ngamasonto ayi-6 emtholampilo we-Vulvar and Sexual Health eProhealth, eWaukesha Memorial Hospital, eWisconsin, kusukela ngoJanuwari 2016 kuya kuDisemba 2019.
Zonke iziguli zazineminyaka engaphezu kwengu-18 ubudala (isilinganiso seminyaka engu-62) futhi zingakhulelwe.
I-estrogen ehambisanayo yabikwa ku-53% weziguli (n = 74). Ukuxilongwa komdlavuza webele kwabhalwa ku-27% (n = 38) kanye ne-lichen sclerosus ku-22% (n = 31).
Iziguli zahlolwa ngaphambi kokwelashwa kokuqala nokwesithathu nge-laser ngemibuzo emibili eqinisekisiwe: i-Female Sexual Function Index (FSFI) kanye ne-Vulvovaginal Symptoms Questionnaire (VSQ). Kugcwaliswe ne-visual analog scale (VAS).
Ukwelashwa kwaqala ngokwenziwa ngesitho sangasese sowesifazane kusetshenziswa i-probe yesitho sangasese sowesifazane kwalandela ukwelashwa ngesitho sangasese sowesifazane okwenziwe ngesandla esihlukile, kusetshenziswa iphethini yesikwele. I-Lidocaine 2% yafakwa ezicutshini zesitho sangasese sowesifazane imizuzu engama-20 ngaphambi kokwelashwa. Ukulungiswa kwe-laser kokwelashwa kwesitho sangasese sowesifazane kanye nesitho sangasese sowesifazane kwafana nezifundo zangaphambilini.
Ukulandelela okumaphakathi bekungamaviki ayi-13.8.
Zonke izikolo ze-FSFI zithuthukile: ngaphambi kokwelashwa 12.7 uma kuqhathaniswa nokwelashwa ngemva kokwelashwa 19.0 (P)
I-VSQ iphinde yabonisa ukuthi imibuzo eyi-18 kwengu-21 ithuthuke kakhulu (P)
Ngaphezu kwalokho, i-VAS ibonise ukuthuthuka okukhulu ekubhekaneni nobuhlungu kanye nokomisa kwe-vulvar kanye ne-vaginal: ukwelashwa kwangaphambi kuka-12.7 no-4.6, ngokulandelana uma kuqhathaniswa nokwelashwa kwangemva kuka-2.4 no-1.5 (zombili i-P
Ngaphezu kwalokho, abesifazane abangu-17 abengeziwe baqala ukuya ocansini ngemva kokwelashwa kwesibili nge-laser. Azikho izehlakalo ezimbi ezinkulu ezibikiwe phakathi kwababambiqhaza ocwaningweni.
“Samangala ukuthi iziguli zilulame ngokushesha ngemva kokwelashwa okukodwa noma okubili,” kusho umphenyi oyinhloko uSarit Aschkenazi MD, MS, umqondisi wezokwelapha eProhealth Waukesha Memorial Hospital. “Kube nokuthuthuka ngisho nakwabesifazane abanezimpawu ezinzima abangasabeli ekwelashweni okuvamile, njenge-estrogen yangaphakathi, noma labo abasebenzisa i-aromatase inhibitors yokuvimbela umdlavuza webele. Sajabula kakhulu ukubona abesifazane abane-lichen sclerosis abane-skin atrophy ethuthukile kakhulu bebonisa izimpawu zokuthuthuka.”
Ukwelashwa nge-laser kucatshangwa ukuthi kusebenza ngokuletha amandla ezicutshini ezingaphansi kwesikhumba, ngomonakalo omncane kakhulu kwi-epithelium ephezu kwayo. Kuvuselela ama-fibroblast ukuthi akhiqize imicu eminingi ye-collagen ne-elastin, kanye nokwandisa okuqukethwe kwamanzi, ukugoba kwesikhumba, kanye nobukhulu be-epithelial yesikhumba sesitho sangasese sowesifazane nesesitho sangasese sowesifazane, ngokusho kuka-Aschkenazi.
“Lokhu kufana nemiphumela evezwayo lapho i-laser isetshenziswa esikhumbeni sobuso,” kusho yena. “I-laser ibilokhu isetshenziswa esikhumbeni sobuso iminyaka engaphezu kweyishumi futhi kuye kwabhalwa ukuthi iphephile. Ukuhlolwa kwesikhumba nakho kubonise le miphumela. Zonke lezi zinguquko zifana nezinguquko ezenzeka lapho i-estrogen ikhona ezicutshini emazingeni angaphambi kokuya esikhathini.”
I-laser ibonakala iyindlela yokwelapha ehlukile ethembisayo yesimo esivamile njenge-vulvovaginal atrophy. “Lokhu kuyindlela entsha lapho i-estrogen ingasebenzi, ingavunyelwe noma ingafunwa,” kusho u-Aschkenazi.
Kodwa-ke, izifundo zokulawula ezingahleliwe ziyadingeka ukuze kunqunywe ngokucacile ukusebenza kahle kokwelashwa nge-laser, kanye nokusungula inani elifanele lamaseshini okwelashwa, izikhawu kanye nokuthi i-booster kufanele iphindwe kangaki.
“Olunye uhlobo lokwelashwa okufanele luhlolwe ukuhlanganisa ukwelashwa nge-laser nokwelashwa ngama-hormone okwenziwa ngaphandle kwemithi, uma kungavinjelwe, njengokwelashwa nge-estrogen noma i-topical dehydroepiandrosterone (DHEA) ukuze kwandiswe ukuthuthukiswa kwezicubu futhi kufezwe umphumela wokubambisana ngemithamo ephansi,” kusho u-Aschkenazi.
Nakuba i-laser itholakale iphephile kubo bonke iziguli ezicwaningwayo, u-Aschkenazi utusa ukusebenzisa izindlela zokwelapha ezivamile zezimpawu ze-vulvovaginal atrophy kuqala ngaphambi kokufaka ukwelashwa nge-laser, nokulandela imingcele yokwelashwa ukuze kugwenywe noma yimiphi imiphumela emibi. Labo ababhekene nalezi zimpawu kufanele futhi balondoloze ukunakekelwa kwesikhumba ngokunciphisa ukucasuka kwesikhumba, izingubo zangaphansi eziqinile, insipho kanye nama-pad abesifazane anephunga elimnandi. “Ukufaka ama-moisturizer angewona ama-hormone kusiza ukugwema ukoma okuhambisana nezimpawu zokunqamuka kokuya esikhathini,” kusho yena.
Ukwelashwa nge-laser ye-CO2 eyingxenye ye-atrophy ye-vulvovaginal Ividiyo Ehlobene:
"Ukuqala kwekhwalithi, Ukwethembeka njengesisekelo, Ukusekelana okuqotho kanye nenzuzo yokubambisana" ngumqondo wethu, ukuze sakhe ngokuphindaphindiwe futhi siphishekele ubuhle be Ukususa Izinwele Ngobuningi , Umshini we-Ipl Wezokwelapha , I-Laser Enamandla Aphezulu , Imikhiqizo yethu ithunyelwe kakhulu eningizimu-mpumalanga ye-Asia Euro-America, kanye nokuthengiswa kwayo yonke izwe lethu. Futhi kuye ngekhwalithi enhle kakhulu, intengo efanelekile, isevisi engcono kakhulu, sithole impendulo enhle evela kumakhasimende aphesheya kwezilwandle. Wamukelekile ukuthi ujoyine nathi ukuze uthole amathuba nezinzuzo ezengeziwe. Samukela amakhasimende, izinhlangano zebhizinisi kanye nabangani abavela kuzo zonke izingxenye zomhlaba ukuthi basithinte futhi bafune ukubambisana ukuze bathole izinzuzo ezifanayo.