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This prospective pilot study aimed to evaluate the effects of associating a neodymium:yttrium–aluminum–garnet (Nd:YAG) laser with a vaginal erbium laser (VEL), as a non-ablative photothermal therapy for superficial dyspareunia in postmenopausal women (PMW) suffering from genitourinary syndrome of menopause (GSM). Two groups of sexually active PMW reporting superficial dyspareunia were selected: one (15 patients, VEL) was treated using an erbium:yttrium–aluminum–garnet laser crystal (XS Fotona SMOOTH; Fotona, Ljubljana, Slovenia) with a wavelength of 2940 nm; in the other group (15 patients, VEL + Nd:YAG) this treatment was followed by Nd:YAG laser (Fotona SP Dynamis, PIANO mode) treatment. Treatment consisted of three laser applications at 30-day intervals. Symptoms were assessed before, after each laser application and after 1 and 3 months from the end of the treatment, using the subjective visual analog scale (VAS) for superficial dyspareunia. Both groups showed a rapid and significant improvement of superficial dyspareunia over time ( p  &lt; 0.001) independently from age and years since menopause. The VEL + Nd:YAG group showed a greater improvement of superficial dyspareunia ( p  &lt; 0.001); this difference was evident since the first treatment and remained stable over time. The addition of Nd:YAG to VEL may induce greater improvement in superficial dyspareunia in PMW with GSM.

Short-term effects of an erbium/neodymium laser combination in superficial dyspareunia: a pilot study