When Mona Lisa doesn’t smile: Symptomatic stenosis of vaginal orifice after fractional CO2 Laser therapy – a Case Report and Review of the literature

Dr Neisha Wratten1

1Dr Neisha K. Wratten, Marden, Australia

In 2017, an Australian series of 102 women with symptoms of GSM treated by fractional CO2 laser was published. 84% of women experienced improvement in their symptoms after 12 -24 months of follow-up. Attention was drawn to the high attrition rates in the study, with the responses decreasing from “less than half” after the third treatment to study completion.

This is a case report of the outcome after treatment of one of the women from the “lost to follow-up ” group, who presented with stenosis of the vaginal orifice 3 years after treatment.

Her symptoms, which commenced with 12 months after 3 episodes of treatment and severely impacted on her quality of life, failed to respond to conservative measures and surgical correction was sought.

A case series of complications after vaginal laser therapy was published earlier this year and, as in this case, the affected women did not represent to the original clinician but sought a second opinion. Given the recent world-wide experience with complications after the use of vaginal mesh and reports of increased uptake of these therapeutic modalities it may be prudent for a central body to establish a site where these incidents can be documented and reviewed.