The first published reports on the use of laser for cervical pathology date back to 1973. Technical advancements in flexible and rigid laser fibers revolutionized video laser laparoscopy in the 1990s. Fractionated lasers have been used to treat vulvovaginal symptoms associated with genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence. Review of available data suggests that fractionated lasers can improve both subjective and objective signs of vaginal atrophy and lichen sclerosus, but the evidence is weak because most of the trials are underpowered, are at risk for bias, and lack long-term follow-up. There is no strong evidence to support fractionated laser therapy for urinary incontinence or low-level laser therapy for chronic pelvic pain. Although short-term, single-arm trials suggest benefit of fractionated laser therapy for genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence, additional adequately powered, prospective, randomized, and longer-term comparative trials are needed before lasers can be recommended for these specific conditions. The purpose of this Clinical Expert Series is to review basic laser biophysics and the mechanism of action for modern fractionated lasers as relevant to the gynecologist. We also summarize safety and effectiveness data for lasers used for some of the most commonly studied gynecologic conditions: the vulvovaginal atrophy component of genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence.

中文翻译：

---

 妇科激光。


第一篇发表的关于激光用于宫颈病理学的报告可以追溯到 1973 年。柔性和刚性激光纤维的技术进步在 20 世纪 90 年代彻底改变了视频激光腹腔镜检查。分段激光已用于治疗与更年期泌尿生殖综合征、硬化性苔藓和尿失禁相关的外阴阴道症状。对现有数据的审查表明，分段激光可以改善阴道萎缩和硬化性苔藓的主观和客观症状，但证据薄弱，因为大多数试验动力不足，存在偏倚风险，并且缺乏长期随访。没有强有力的证据支持分段激光治疗尿失禁或低强度激光治疗慢性盆腔疼痛。尽管短期、单臂试验表明分段激光治疗对更年期泌尿生殖系统综合征、硬化性苔藓和尿失禁有好处，但在推荐激光治疗之前，还需要进行其他充分有力的、前瞻性的、随机的和长期的比较试验。这些具体条件。本临床专家系列的目的是回顾基本激光生物物理学以及与妇科医生相关的现代分段激光的作用机制。我们还总结了激光用于一些最常研究的妇科疾病的安全性和有效性数据：更年期泌尿生殖综合征的外阴阴道萎缩、硬化性苔藓和尿失禁。