Efficacy of Fractional CO 2 Laser, Promestriene, and Vaginal Lubricant in the Treatment of Urinary Symptoms in Postmenopausal Women: A Randomized Clinical Trial

Background and Objectives Evaluating the efficacy of the fractional CO 2 laser, promestriene, and vaginal lubricant to treat urinary symptoms in women with genitourinary syndrome of menopause. Study Design/Materials and Methods We conducted a randomized clinical trial with 72 postmenopausal women aged 50 years or older. The participants were randomized to one intervention each in three treatment groups fractional CO 2 laser, promestriene, and vaginal lubricant. Urinary symptoms were assessed prior to treatment and 2 weeks after treatment completion using validated questionnaires, the International Consultation on Incontinence Questionnaire (ICIQ‐UI SF), and the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ‐OAB). Results There was a significant reduction in the total ICIQ‐UI SF score in the intragroup comparison (baseline vs. week 14) of the CO 2 laser group ( P  = 0.004). This group also showed a statistically significant reduction in nocturia (1.33 ± 0.87 vs. 1.00 ± 0.76, respectively; P  = 0.031). In the intergroup comparison after treatment, nocturia in the lubricant group had worsened compared with that of the other two groups ( P  = 0.002). Regarding the total ICIQ‐OAB score, the results of the CO 2 laser group were superior to those of the lubricant group in the intergroup comparison (7.76 ± 3.36, P  = 0.020; analysis of variance P  = 0.038). Conclusion The results were significantly different between the intravaginal fractional CO 2 laser and topical estrogen groups for treating urinary symptoms related to the genitourinary syndrome of menopause. Further controlled and randomized studies are needed. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.