Is vaginal fractional CO2 laser treatment effective in improving overactive bladder symptoms in post-menopausal patients? Preliminary results.

OBJECTIVE: To evaluate the role of vaginal fractional CO2 laser treatment in the relief of Overactive Bladder (OAB) symptoms in post-menopausal women. PATIENTS AND METHODS: Post-menopausal women who complained of one or more symptoms related to vulvo-vaginal atrophy (VVA), who experienced symptoms of OAB and who underwent vaginal treatment with fractional CO2 laser were enrolled in the study. At baseline (T0) and 30 days post-treatment T1), vaginal status (using Vaginal Health Index - VHI), subjective intensity of VVA symptoms (using a visual analog scale - VAS) and micturition diary were evaluated. OAB symptoms were also assessed using a validated questionnaire. RESULTS: Thirty patients were enrolled. A statistically significant improvement in VVA symptoms was observed and in VHI at T1 (p < 0.0001). A significant improvement was also identified in the micturition diary, in number of urge episodes and OAB-q (p < 0.0001). Nine of the 30 patients suffered from incontinence episodes and had improved at T1. CONCLUSIONS: We showed that fractionated CO2 laser vaginal treatment has proved to be effective in improving OAB symptoms in post-menopausal women. Moreover, it is a safe and efficacious measure for the relief of VVA related conditions. Further long-term studies are needed to confirm these preliminary results.

Application of a tapered teflon dilator to percutaneous transluminal coronary angioplasty.

A tapered teflon dilator has been applied to 12 cases of percutaneous transluminal coronary angioplasty (PTCA). The technique was first used to predilate stenoses that could not initially be crossed with low profile over the wire PTCA balloons. In the first five cases, three angioplasties that would have been failures were converted to successes by this method. The dilator was used in place of a balloon catheter as an initial step to assess the ability of a guidewire to cross a lesion to reduce cost in five additional cases. Modification of an existing family of peripheral vascular dilators is described. The method of application of this technique to PTCA is outlined.