Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up
Abstract Introduction Despite the advances in surgical and clinical approaches, there is no consensus regarding the best line of treatment from rectovaginal fistula (RVF). Faced with a challenging scenario in the approach of RVF, the fractional CO2 laser receives attention as a possible form of trea...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-12-01
|
| Series: | BMC Research Notes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13104-023-06666-8 |
| _version_ | 1797377176953159680 |
|---|---|
| author | Denise Gasparetti Drumond Camila de Moraes Sarmento Condé Júlio Maria da Fonseca Chebli Liliana Andrade Chebli Samuel Drumond Esperança Neila Maria de Góis Speck |
| author_facet | Denise Gasparetti Drumond Camila de Moraes Sarmento Condé Júlio Maria da Fonseca Chebli Liliana Andrade Chebli Samuel Drumond Esperança Neila Maria de Góis Speck |
| author_sort | Denise Gasparetti Drumond |
| collection | DOAJ |
| description | Abstract Introduction Despite the advances in surgical and clinical approaches, there is no consensus regarding the best line of treatment from rectovaginal fistula (RVF). Faced with a challenging scenario in the approach of RVF, the fractional CO2 laser receives attention as a possible form of treatment. Objectives A single-center, prospective, open-label study evaluating the effectiveness and safety of laser therapy for RVF treatment. Subjects and methods The total of 15 patients was recruited at the Juiz de Fora University Hospital between August 2018 and July 2022. Inclusion criteria were presence of clinically suspects RVF of any etiology confirmed by pelvic magnetic resonance image (MRI) and gynecological examination. Five fractional CO2 laser sessions with monthly interval followed by complete evaluation through clinical examination and pelvic MRI were performed for all patients after the completion of treatment. Analysis of sexual function before and after the treatment was performed using Female Sexual Quotient (FSQ). Results The evaluation through physical examination showed no persistent inflammatory signs in the vagina for all patients. Additionally, 10 of out 15 (67.7%) patients achieved clinical remission of RVF symptoms, while 33.3% patients reported significant improvement. Of note, five patients who did not have previous sexual activity returned to regular sexual activity while seven patients who have baseline sexual activity had improvement in their sexual function as assessed by the FSQ. Three out of four ostomized patients had their ostomy reversed and remained without complains. All six patients with RVF secondary to Crohn’s disease reported a marked improvement in symptoms and sexual function. In seven (47%) patients radiological remission was confirmed by pelvic MRI. Conclusion CO2 fractional laser can be considered a promising and safe therapeutic alternative for the management of RVF. |
| first_indexed | 2024-03-08T19:48:58Z |
| format | Article |
| id | doaj.art-088b18a244fe415d80817122cbbb3e09 |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-03-08T19:48:58Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-088b18a244fe415d80817122cbbb3e092023-12-24T12:09:05ZengBMCBMC Research Notes1756-05002023-12-0116111010.1186/s13104-023-06666-8Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-upDenise Gasparetti Drumond0Camila de Moraes Sarmento Condé1Júlio Maria da Fonseca Chebli2Liliana Andrade Chebli3Samuel Drumond Esperança4Neila Maria de Góis Speck5Department of Surgery, Faculty of Medicine, Universidade Federal de Juiz de ForaUniversidade Federal de Juiz de ForaDepartment of Medicine, Faculty of Medicine, Inflammatory Bowel Disease Center, Universitary Hospital, Universidade Federal de Juiz de ForaDepartment of Medicine, Faculty of Medicine, Inflammatory Bowel Disease Center, Universitary Hospital, Universidade Federal de Juiz de ForaHospital Israelita Albert EinsteinDepartment of Gynecology, Universidade Federal de São PauloAbstract Introduction Despite the advances in surgical and clinical approaches, there is no consensus regarding the best line of treatment from rectovaginal fistula (RVF). Faced with a challenging scenario in the approach of RVF, the fractional CO2 laser receives attention as a possible form of treatment. Objectives A single-center, prospective, open-label study evaluating the effectiveness and safety of laser therapy for RVF treatment. Subjects and methods The total of 15 patients was recruited at the Juiz de Fora University Hospital between August 2018 and July 2022. Inclusion criteria were presence of clinically suspects RVF of any etiology confirmed by pelvic magnetic resonance image (MRI) and gynecological examination. Five fractional CO2 laser sessions with monthly interval followed by complete evaluation through clinical examination and pelvic MRI were performed for all patients after the completion of treatment. Analysis of sexual function before and after the treatment was performed using Female Sexual Quotient (FSQ). Results The evaluation through physical examination showed no persistent inflammatory signs in the vagina for all patients. Additionally, 10 of out 15 (67.7%) patients achieved clinical remission of RVF symptoms, while 33.3% patients reported significant improvement. Of note, five patients who did not have previous sexual activity returned to regular sexual activity while seven patients who have baseline sexual activity had improvement in their sexual function as assessed by the FSQ. Three out of four ostomized patients had their ostomy reversed and remained without complains. All six patients with RVF secondary to Crohn’s disease reported a marked improvement in symptoms and sexual function. In seven (47%) patients radiological remission was confirmed by pelvic MRI. Conclusion CO2 fractional laser can be considered a promising and safe therapeutic alternative for the management of RVF.https://doi.org/10.1186/s13104-023-06666-8CO2 laserTreatmentRectovaginal fistula |
| spellingShingle | Denise Gasparetti Drumond Camila de Moraes Sarmento Condé Júlio Maria da Fonseca Chebli Liliana Andrade Chebli Samuel Drumond Esperança Neila Maria de Góis Speck Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up BMC Research Notes CO2 laser Treatment Rectovaginal fistula |
| title | Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up |
| title_full | Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up |
| title_fullStr | Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up |
| title_full_unstemmed | Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up |
| title_short | Combined clinical and radiological remission of rectovaginal fistulas using fractional CO2 vaginal laser: a case series and medium-term follow-up |
| title_sort | combined clinical and radiological remission of rectovaginal fistulas using fractional co2 vaginal laser a case series and medium term follow up |
| topic | CO2 laser Treatment Rectovaginal fistula |
| url | https://doi.org/10.1186/s13104-023-06666-8 |
| work_keys_str_mv | AT denisegasparettidrumond combinedclinicalandradiologicalremissionofrectovaginalfistulasusingfractionalco2vaginallaseracaseseriesandmediumtermfollowup AT camilademoraessarmentoconde combinedclinicalandradiologicalremissionofrectovaginalfistulasusingfractionalco2vaginallaseracaseseriesandmediumtermfollowup AT juliomariadafonsecachebli combinedclinicalandradiologicalremissionofrectovaginalfistulasusingfractionalco2vaginallaseracaseseriesandmediumtermfollowup AT lilianaandradechebli combinedclinicalandradiologicalremissionofrectovaginalfistulasusingfractionalco2vaginallaseracaseseriesandmediumtermfollowup AT samueldrumondesperanca combinedclinicalandradiologicalremissionofrectovaginalfistulasusingfractionalco2vaginallaseracaseseriesandmediumtermfollowup AT neilamariadegoisspeck combinedclinicalandradiologicalremissionofrectovaginalfistulasusingfractionalco2vaginallaseracaseseriesandmediumtermfollowup |