Fractional CO2 Laser, Radiofrequency and Topical Estrogen for Treating Genitourinary Syndrome of Menopause: A Pilot Study Evaluating the Vulvar Vestibule.

Background and Objectives: Genitourinary syndrome of menopause (GSM) affects more than half of postmenopausal women. This study aimed to evaluate the clinical and histological aspects of microablative fractionated CO2 laser (CO2L), microablative fractionated radiofrequency (RF) and intravaginal estrogen (ET) therapy as GSM treatments for the vulvar vestibule. Materials and Methods: This study included postmenopausal women with at least one moderate-to-severe complaint of GSM. Women in the CO2L and RF groups received three monthly sessions of outpatient vulvovaginal therapy. The procedures were performed 30 min after applying 4% lidocaine gel to the vulva and vaginal introitus. Vulvar vestibular pain was assessed after each application using a 10-point VAS. A follow-up evaluation was performed 120 days after beginning each treatment. Digital images of the vulva were obtained and a 5-point Likert scale (1 = much worse, 2 = worse, 3 = neutral, 4 = better, 5 = much better) was used to assess the global post-treatment women's impression of improvement regarding GSM. Results: A significant change in clinical aspects of the vulva was observed after all treatments with a reduction in the atrophic global vulvar aspect and an enhancement of the trophic aspect. High satisfaction was also reported after treatment according to the Likert scale evaluation: CO2L (4.55 ± 0.97), RF (4.54 ± 0.95), CT (4 ± 1.41), p = 0.066. Histological evaluation revealed enhanced dermal papillae before pre-treatment, significantly reducing post-treatment in all groups (p = 0.002). No unintended effects were reported. Conclusions: CO2L, RF, and ET significantly improved GSM concerning the vulvar vestibule at the 4 months follow-up.

Comparative assessment of the degradation of 2-methylisoborneol and geosmin in freshwater using advanced oxidation processes.

Traditional methodologies of conventional drinking water treatment are unable to remove some chemical compounds, such as those that cause odor and taste in drinking water. The present work aims to evaluate the efficiency of advanced oxidations processes, using UV radiation, O3 and O3 + UV in the degradation of geosmin (GSM) and 2-methylisoborneol (2-MIB) in synthetic samples. The efficiency of the processes was monitored by Gas Chromatography coupled with Mass Spectrometry using solid phase microextration technique. Experiments were carried out for 45 min with samplings every 15 min. The degradation results showed that UV radiation alone was not efficient for the degradation of both compounds. The fasted decay was observed by the combined use of O3 and UV with an ozone concentration of 15.84 mg L-1. Under these conditions, the final concentration of GSM was below the limit of quantification, so that approximately 99% of the initial concentration was degraded, while 2-MIB was degraded by 95%. With the same O3 concentration without the use of UV radiation, 63% and 65.7% of MIB and GSM, respectively, were removed. Higher efficiency of the treatment was observed with a higher O3 concentration which allows a shorter reaction time.