{"paper_id":"5cce25d3-8f2d-4b86-8ddc-b13224b2a00c","body_text":"Abstract\nChildbirth is a great change in woman life because of hormonal, physical and psychological alterations that are associated with this process. Dyspareunia and perineal pain are commonly reported symptoms in the postpartum period, mainly due to perineal trauma, lacerations, episiotomy, and forceps or vacuum use at delivery. Among non-pharmacological treatment, a new trend is gaining popularity, which is the energy-based therapy, including fractional micro-ablative CO2 laser. We conducted a multicentric retrospective study to assess the efficacy and the possible side effects of CO2 laser treatment on transient vulvovaginal atrophy and perineal postpartum pain related to puerperium and breastfeeding period. All patients were submitted to 3 or 4 sessions of CO2 laser treatment. As per protocol, an initial, intermediate (after 2 sessions) and final (3 months after the last cycle) evaluation of the symptoms were made, using a VAS (Visual Analogue Scale 0–10). We also compared this group of patients with a control group with no treatment. At the final evaluation, patients showed a significant improvement for dyspareunia (VAS from 7.95 to 3.14, p < 0.0001). A significant improvement was also registered in pain at the vaginal orifice (VAS from 6.94 to 2.05, p = 0.0001), dryness (VAS from 6.6 to 2.9, p = 0.0022), itching (VAS from 4.5 to 1.16, p = 0.0053), heat (VAS from 3 to 0, p = 0.0119) and burning (VAS from 5.5 to 1.6, p = 0.0013) if compared with the control group. Quality of life for the women during the breastfeeding and puerperium is important and training is mandatory to avoid side effects in order to improve the CO2 laser performance.\nSimilar content being viewed by others\nReferences\nGün İ, Doğan B, Özdamar Ö (2016) Long- and short-term complications of episiotomy. Turk J Obstet Gynecol 13(3):144–148\nAbdool Z, Thakar R, Sultan AH (2009) Postpartum female sexual function. Eur J Obstet Gynecol Reprod Biol 145(2):133–137\nCarroli G, Mignini L (2009) Episiotomy for vaginal birth. Cochrane Database Syst Rev (1):CD000081. https://doi.org/10.1002/14651858.CD000081.pub2 Review. Update in: Cochrane Database Syst Rev. 2017 Feb 08;2:CD000081. PubMed PMID:19160176; PubMed Central PMCID: PMC4175536\nEast CE, Sherburn M, Nagle C et al (2012) Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. 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Rev Esc Enferm USP 47(3):555–561\nAcknowledgements\nThank you to all the collaborators of the LARA (LAser Regeneration Advanced) group.\nAuthor information\nAuthors and Affiliations\nContributions\nDaniela Luvero, writing original draft\nMaurizio Filippini and Annalisa Pieralli, formal analysis and methodology\nRoberto Angioli, conceptualisation, writing review and editing\nStefano Salvatore and Miriam Farinelli, supervision\nCorresponding author\nEthics declarations\nEthical approval\nEthical approval was waived by the local Ethics Committee of University Campus Bio Medico of Rome; in view of the retrospective nature of the study, all the procedures being performed were part of the routine care.\nConflict of interest\nThe authors declare that they have no conflict of interest.\nInformed consent\nAll patients enrolled signed an informed consent form.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nLuvero, D., Filippini, M., Salvatore, S. et al. The beneficial effects of fractional CO2 laser treatment on perineal changes during puerperium and breastfeeding period: a multicentric study. Lasers Med Sci 36, 1837–1843 (2021). https://doi.org/10.1007/s10103-020-03212-x\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s10103-020-03212-x","source_license":"CC0","license_restricted":false}