Efficacy of Erbium and CO2 Genital Laser Treatment on Genitourinary Syndrome in Female Patients After Breast Cancer: A Scoping Review

TL;DR

This review examines how CO2 and erbium lasers help treat genitourinary syndrome in women who have survived breast cancer.

Contribution

The study provides a comprehensive overview of laser therapy use for this condition in breast cancer survivors since 2017.

Findings

Both CO2 and erbium lasers are safe and effective for treating genitourinary syndrome in breast cancer survivors.

13 out of 20 studies concluded that laser therapy is as effective as standard treatments for this condition.

More large-scale studies are needed to standardize protocols and confirm long-term efficacy.

Abstract

This scoping review aimed to synthesize the existing scientific literature on the methods, tools, and strategies employed in vaginal laser therapy for treating genitourinary syndrome in breast cancer survivors.

A systematic search was conducted in August 2024 across six electronic databases—MEDLINE (via PubMed), Embase (Elsevier), Scopus (Elsevier), Cochrane Library (Central), Virtual Health Library (VHL), and Web of Science (Clarivate Analytics)—for studies reporting the use of CO2 or erbium lasers in breast cancer survivors. The search included articles in all languages and used MeSH terms and database‐specific adaptations.

A total of 2372 studies were identified through the electronic databases. After excluding 458 duplicates, 2134 titles and abstracts were screened. Thirty full‐text records were assessed for eligibility, of which 10 were excluded for incomplete results and different technologies. Ultimately, 1189 patients out of 20 studies were selected for inclusion in this review: 14 studies used CO2 laser, 5 used erbium laser, and 1 used both technologies. This review showed that use of vaginal lasers to approach GSM in BSC patients is being used since 2017, and 13 out of 20 studies concluded for the safety and efficacy of vaginal laser to treat GSM in BCS patients, comparable to standard treatment.

Both CO2 and erbium lasers appear to be safe and effective treatment options for breast cancer survivors with genitourinary syndrome. New larger, multicenter studies are needed to enhance safety, standardize treatment protocols, and provide further evidence on the efficacy of these therapies in this patient population.

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