RESUMEN
This committee opinion reviews the laser-based vaginal devices for treatment of genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence. The United States Food and Drug Administration has issued a warning for unsubstantiated advertising and use of energy-based devices. Well-designed case-control studies are required to further investigate the potential benefits, harm, and efficacy of laser therapy in the treatment of genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence. The therapeutic advantages of nonsurgical laser-based devices in urogynecology can only be recommended after robust clinical trials have demonstrated their long-term complication profile, safety, and efficacy.
Asunto(s)
Láseres de Estado Sólido/uso terapéutico , Terapia por Luz de Baja Intensidad , Incontinencia Urinaria de Esfuerzo/terapia , Vagina/patología , Enfermedades Vaginales/terapia , Vulva/patología , Atrofia/radioterapia , Atrofia/cirugía , Femenino , Humanos , Láseres de Estado Sólido/efectos adversos , Terapia por Luz de Baja Intensidad/efectos adversos , Menopausia , SíndromeRESUMEN
Little is known about the pathophysiology of pelvic organ prolapse (POP). In 1996, Jackson presented a hypothesis on pelvic floor connective tissue that tried to explain the development of POP on a molecular level. The objective of this review is to test the hypothesis against recent literature. The method used was a review of literature. The association between POP and connective tissue metabolism is well established. However, the causality of this association is unclear. The characteristics of the pelvic floor connective tissue of POP patients relate to tissue repair. To resolve the question of cause and effect, the role of fibroblasts in producing the extracellular matrix should be clarified. With these data, the use of autologous or allogenic stem cells in the treatment of POP may come in sight. Recent literature supports the hypothesis of Jackson but does not resolve long-standing questions on the aetiology of POP.