Not all lasers are the same: a scoping review evaluating laser therapy for vulvodynia.

INTRODUCTION: Lasers are commonly used for treating various vaginal/vulvar conditions. To date, there is to our knowledge no available literature review on the effects of different types of lasers for the treatment of women with vulvodynia, a condition that causes chronic pain in the vulvar area. OBJECTIVES: We sought to review the literature and summarize the existing published evidence regarding the effects of lasers for the treatment of women with vulvodynia. METHODS: A scoping review with a systematic search was conducted that included studies investigating the use of laser treatment in women with vulvodynia. The National Heart, Lung, and Blood Institute Study Quality Assessment Tools were used for the quality assessment. The type of laser, effects on pain and function, and participants' perceived improvement as well as adverse events were analyzed. RESULTS: Eight studies investigating laser therapy were included in the analysis: 1 randomized controlled trial, 5 before-after studies, 1 nonrandomized intervention study, and 1 case report. Several types of laser therapies were identified, ranging from mild noninvasive photobiomodulation to more invasive ablative procedures. Of the 6 studies that included pain outcomes, 3 studies showed statistically significant improvements from baseline to follow-up, and 3 demonstrated a reduction in pain from subjectively interpreted data. Similarly, each of the 2 studies investigating sexual function also reported an improvement (based only on subjective interpretation). Of the 2 studies with a comparison group, neither study was adequately powered to detect between-group differences. Furthermore, 57%-78% of participants reported improvement, with 1 study showing a greater statistically significant improvement in the low-level laser therapy patient group compared to the sham laser group. Outcomes and adverse events varied depending on the type of laser used. CONCLUSIONS: Although these studies demonstrated some benefits of laser therapy for the treatment of vulvodynia, these findings should be interpreted with caution given the scarcity of the included studies that were robust and sufficiently powered. Future research should focus on conducting well-designed randomized controlled trials to evaluate the efficacy of different types of lasers in the treatment of vulvodynia.

Radiofrequency therapy for severe idiopathic vulvodynia.

OBJECTIVE: The study aimed to provide a description of a new and a hopeful possibility in the treatment of severe vulvodynia, which does not respond to treatments used so far. MATERIALS AND METHODS: The use of radiofrequency therapy in vulvodynia treatment is described for the first time. This method was suggested by a neurosurgeon after applying all available possibilities. RESULT: In this article, we are reporting on the successful use of the pulsed radiofrequency treatment in a patient with intractable chronic vulvodynia. CONCLUSIONS: To our knowledge, this is the first report of a successful use of pulsed radiofrequency in the treatment of chronic vulvodynia. If efficacy of pulsed radiofrequency is confirmed by more studies, it would be a welcome addition to the treatment modalities used to treat this sometimes truly intractable condition.