A randomized clinical study of the treatment of white lesions of the vulva with a fractional ultrapulsed CO2 laser.

BACKGROUND: White lesions of the vulva are a common vulvar disease of unclear etiology. Although a variety of treatments have been used to treat the disease in clinical practice, there is currently a lack of effective radical therapies. This study aimed to compare the feasibility and effectiveness of fractional ultrapulsed CO2 laser with that of high-intensity focused ultrasound in the treatment of white lesions of the vulva. METHODS: A total of 60 patients with pruritus vulvae who were treated at the Center for Diagnosis and Treatment of Cervical Diseases in our hospital between December, 2017, and December 2018 were enrolled in this study. The possibility of malignant lesions of the vulva was ruled out by histopathological diagnosis following colposcopic biopsy. The patients were randomly divided into two groups: a laser treatment group (group L, n=30) and a focused ultrasound treatment group (group U, n=30). The patients were monitored for changes in signs and symptoms during and after treatment, and the treatment outcomes of the two groups were compared. RESULTS: The local symptoms of pruritus were alleviated by both the fractional ultrapulsed CO2 laser and high-intensity focused ultrasound. The patients in group L had no significant adverse reactions during the operation and needed no special postoperative treatment. The total effective rate in group L was 96.7%. In group U, five patients felt mild burning during the operation, painful blisters arose on the skin of the ablated area, and long-lasting local edema was observed. Seven patients had subcutaneous nodules. The total effective rate in group U was 90.0%. CONCLUSIONS: Fractional ultrapulsed CO2 laser is a minimally invasive, effective, and safe treatment for white lesions of the vulva. It causes few complications and does not affect the daily and working life of patients. Therefore, it should be widely applied in clinical practice.

Clinical study in treatment of leukoplakia vulvae with high-intensity focused ultrasound / 解放军医学杂志

Objective To evaluate the feasibility and efficacy of treatment of leukoplakia vulvae with high-intensity focused ultrasound. Methods 65 patients with leukoplakia of the vulva were treated with high-intensity focused ultrasound. The patients were followed up after the treatment, and the symptoms including itch of the vulva, color change, the elasticity of the vulva lesions, and release of adhesions were observed and evaluated at the different times after treatment. Result All of the patients experienced relief in different degree (the ratio of effectiveness was 100%). Of them 28 patients were complete cured, 29 were distinctly improved, 8 were improved. In 5 patients there was a recrudescence with mild itch 2-3 months after treatment, but there was still a positive response to the second course of treatment. Conclusions High-intensity focused ultrasound is a highly effective instrument in the treatment of leukoplakia of the vulva. The treatment not only stops itch, but enables the color and elasticity of the vulva to recover as well.