二氧化碳激光治疗绝经期泌尿生殖系统综合征:随机对照试验的荟萃分析

IF 2.4 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Yihua Ni, Junyu Lian
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引用次数: 0

摘要

绝经期泌尿生殖系统症状(GSM)影响约50%的绝经后妇女。最近,CO2激光治疗已被用于治疗GSM,但没有高质量的证据。本文综述了CO2激光治疗GSM的有效性。检索PubMed、Embase、Web of Science、CENTRAL和Scopus数据库,检索截至2023年6月30日发表的随机对照试验(rct),比较CO2激光和假激光治疗对GSM管理的影响。关注的结果包括女性性功能指数(FSFI)、阴道健康指数(VHI)和性交困难、干燥、灼烧、瘙痒和排尿困难的视觉模拟量表(VAS)。本综述和荟萃分析共纳入7项随机对照试验,其中6/7项研究采用三次激光治疗,间隔4 - 8周。Meta分析显示FSFI无统计学差异[平均差异(MD), 1.48;95% ci, 5.85, 2.89;I2=45%]和VHI评分(MD, 0.18;95% ci, 1.66, 1.31;I2 =72%)。Meta分析还显示,性交困难的VAS评分无统计学差异(MD, 1.63;95%可信区间;- 4.06, 0.80;I2=91%),干燥度(MD, - 1.30;95% ci, 3.14, 0.53;I2=75%),燃烧(MD, - 0.76;95% ci,‑2.03;0.51 I2=56%),瘙痒(MD, - 0.28;95% ci, 0.95, 0.38;I2=0%)和排尿困难(MD, 0.15;95% ci, 0.37, 0.67;I2=23%)。纳入的rct偏倚风险较低。总之,高质量假对照随机对照试验的荟萃分析表明,CO2可能对GSM没有任何有益影响。在这一研究领域的meta分析中,有限的数据和高度的异质性是未来随机对照试验需要解决的重要限制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carbon dioxide laser therapy for the management of genitourinary syndrome of menopause: A meta‑analysis of randomized controlled trials
Genitourinary symptoms of menopause (GSM) affect ~50% of women after menopause. Recently, CO2 laser therapy has been used for managing GSM but without high quality evidence. The present review assessed the effectiveness of CO2 laser therapy in the management of GSM. PubMed, Embase, Web of Science, CENTRAL and Scopus databases were searched for randomized controlled trials (RCTs), published up to June 30, 2023, comparing CO2 laser and sham laser treatments for GSM management. The outcomes of interest included Female Sexual Function Index (FSFI), Vaginal Health Index (VHI) and visual analog scale (VAS) for dyspareunia, dryness, burning, itching and dysuria. A total of seven RCTs were included in the review and meta‑analysis, with 6/7 studies using three sessions of laser therapy, 4‑8 weeks apart. Meta‑analysis demonstrated no statistically significant difference in FSFI [mean difference (MD), ‑1.48; 95% CI, ‑5.85, 2.89; I2=45%] and VHI scores (MD, ‑0.18; 95% CI, ‑1.66, 1.31; I2 =72%) between laser and control groups. Meta‑analysis also demonstrated no statistically significant difference in VAS scores for dyspareunia (MD, ‑1.63; 95% CI; ‑4.06, 0.80; I2=91%), dryness (MD, ‑1.30; 95% CI, ‑3.14, 0.53; I2=75%), burning (MD, ‑0.76; 95% CI, ‑2.03; 0.51 I2=56%), itching (MD, ‑0.28; 95% CI, ‑0.95, 0.38; I2=0%) and dysuria (MD, 0.15; 95% CI, ‑0.37, 0.67; I2=23%) between the groups. The included RCTs had low risk of bias. In conclusion, meta‑analyses of high‑quality sham‑controlled RCTs indicated that CO2 may not have any beneficial effect on GSM. Limited data and high heterogeneity in meta‑analyses in this area of research are important limitations that need to be addressed by future RCTs.
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Experimental and therapeutic medicine
Experimental and therapeutic medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
1.50
自引率
0.00%
发文量
570
审稿时长
1 months
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