What is fractional CO2 laser?

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Laser technology has been used extensively in gynecology since the first use of the CO2 laser in the treatment of cervical erosions in 1973. Although the laser became extremely popular in the late 1980s, the efforts to decrease health care costs during the early nineties prompted people to prefer less expensive technologies, and this preference diminished the demand for laser energy and its use. However, laser has recently made significant technological progress, and has become popular again, starting to take its deserved place in many fields of medicine.

The CO2 laser has a wavelength of 10,600 nm. It is extremely safe because its penetration depth is 0.1 to 0.5 mm and the width of its thermal damage to adjacent tissues is 0.5 mm. This safety makes it usable in sensitive areas such as the bladder, ureter, and intestinal serosa, where the use of an electrocautery device would not be safe. Besides evaporation, the CO2 laser can also be used for excision and incision when its power density is increased.

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Contrary to popular belief, fractional CO2 laser therapy is not a new procedure. It was developed in 2004 and there are many studies in the medical literature that support its reliability, and it is used safely in many surgical branches. Fractional laser treatment is performed by splitting the laser beam into multiple microbeams. As a result of this splitting process, the laser creates a lesion-focused destruction area while not affecting the normal tissues; and therefore fractional laser treatment has fewer side effects compared to other laser treatment procedures.

Fractional CO2 lasers are also used for other purposes with the use of different set ups and applicators. These include removal of skin tags, facial rejuvenation, reduction of surgical scars, genital bleaching, and the treatment of genital warts, cervical wounds, vaginal dryness and painful sexual intercourse, vulvovaginal atrophy (thinning of the skin) due to menopause, urinary incontinence, freckles, spots.

 

How is Laser Vaginal Tightening (LVT) Performed?

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The patient sits on the gynecological table. The inside of the vagina is made visible using the vaginal speculum that we use for examination. The inside of the vagina is dried using gauze pads to increase the effect of the laser. Then the device you see in the photo is inserted into the vagina, and a great number of micron-scale laser pulses are applied to the vaginal wall. When the procedure is performed on patients with urinary incontinence, we observe that the incontinence improves even after the first session, because these laser pulses also increase the collagen production around the urinary tract.

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The procedure does not require the patient to be hungry and thirsty. Anesthesia is not required because the inside of the vagina does not feel pain due to laser pulses. The procedure takes 10 to 15 minutes. After the procedure, the patient can return to work, she does not need to stay away from his daily routines. It is normal to have a dark discharge during the recovery period of the vagina. To allow for this recovery, the patient is advised to avoid having sexual intercourse for 7 days after the procedure. After 7 days, the patient can have sexual intercourse.

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In general, we recommend 2 sessions at a 1-month interval. In some cases, the number of sessions can be up to 3-4. Laser treatment can be repeated once a year to maintain its effect.

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Both the patient and her sexual partner begin to feel the effect of the procedure after 3 weeks. The optimum effect is achieved 3 to 4 weeks after the 2nd session.

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