Sham-controlled study on the short-term effects of Er:YAG laser application in a sheep model for vaginal atrophy
IUGA Academy. Hympanova L. Jun 30, 2018; 212850; 468
Lucie Hympanova
Lucie Hympanova

Access to Premium content is currently a membership benefit.

Click here to join IUGA or renew your membership.

Discussion Forum (0)
Rate & Comment (0)


Sham-controlled study on the short-term effects of Er:YAG laser application in a sheep model for vaginal atrophy

Hympanova, L1; Rynkevic, R2; Monteiro Carvalho Mori da Cunha , MG3; Diedrich , C4; Blacher, S5; De Landsheere , L6; Krofta, L7; Roovers , J4; Deprest , J3

1: Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic; 2: INEGI, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal ; 3: Department of Development and Regeneration, KU Leuven, Leuven, Belgium; 4: Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands; 5: Laboratory of Tumor and Development Biology, GIGA-Cancer, Institute of Pathology, University of Liège, Belgium; 6: Department of Obstetrics and Gynaecology, University of Liège, Liège, Belgium; 7: Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic

Introduction: Genitourinary atrophy is a debilitating disease. Vaginal estrogen suppletion is the gold standard of therapy, yet some women may not want or should not get this treatment. Vulvovaginal laser therapy is suggested as an alternative, yet the scientific basis for the physiologic principles of this intervention is limited. Therefore an animal model may be useful.

Objective: In sheep of reproductive age, we aimed to document vaginal changes after ovariectomy and measure the short-term effects of Er:YAG laser as used clinically.

Methods: On day 0, sixteen sheep underwent ovariectomy. They were randomized to undergo either sham or vaginal Er:YAG laser (fluence 3 J/cm²; spot size 7 mm²; 4 pulses; 5 passages) application at d70 after ovariectomy. Vaginal biopsies were performed at d60, d71, d73 and d77. Primary outcome was vaginal epithelial thickness. Secondary outcomes included indicators of atrophy, i.e. vaginal health index, pH, cytology, morphology (glycogen, collagen, elastin, mitosis, apoptosis).

Results: Sixty days after ovariectomy evaluated morphology was comparable between laser and sham group. The epithelial thickness in sham animals was 76.0±3.8µm, the glycogen positive layer was 10.3±4.4µm, pH 6.8±0.1 and vaginal health index 17.8±1.0. The first day after laser application (d71) few white macroscopic foci were visible and the pH was higher in laser group (sham: 7.2±0.1 vs. laser: 7.6±0.1, p<0.05, Figure 1). Both findings disappeared within 3 days. Seven days after laser (d77) the epithelial thickness was thicker in laser group (sham: 71.4±5.2 vs. laser: 93.0±3.6, p<0.05, Figure 1). There were no differences in vaginal health index, cytology, glycogen, elastin, collagen, mitotic and apoptotic activity. We did not observe any adverse effect of laser application.

Conclusions: Vaginal epithelial thickness sixty days after ovariectomy fell within the reported range of premenopausal sheep (40-180µm). In this study, we have not established whether ovariectomy results in statistically relevant atrophical changes already within 60 days after the ovariectomy. Vaginal Er:YAG laser application was feasible and did not cause adverse effects. Laser application had some effects on the short term, i.e. higher pH and thicker epithelium compared to sham. Experiments will be completed with a longer interval between ovariectomy and laser application.


Work supported by industry: yes, by Fotona.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings