Fractional CO₂ Laser Treatment for Female Vaginal Relaxation Syndrome: A Prospective Study

Vaginal relaxation syndrome (VRS) is a common condition that adversely affects women's quality of life. Conventional non-surgical therapies provide limited benefit for patients with mild to moderate disease. Fractional CO₂ laser (FxCO₂) therapy has emerged as a minimally invasive treatment option; however, its long-term efficacy and safety remain to be fully elucidated.

To prospectively evaluate the efficacy and safety of FxCO₂ in women with mild to moderate VRS.

This prospective self-controlled study enrolled 101 women diagnosed with mild to moderate VRS. All participants underwent three sessions of FxCO₂ treatment at 4-week intervals. Clinical outcomes were assessed at baseline and at 1, 3, 6, and 12 months after the final treatment using the Female Sexual Function Index (FSFI), Vaginal Laxity Questionnaire (VLQ), and Vaginal Health Index (VHI). Adverse events were recorded throughout the follow-up period.

All primary outcome measures improved following treatment. The mean FSFI total score increased from 21.4 to 25.9, the VLQ score improved from 2.68 to approximately 3.0, and the VHI score increased from 17.0 to 19.25 (all p < 0.001). Subgroup analyses indicated that treatment efficacy was not significantly influenced by parity, age, or the presence of concomitant urinary incontinence. Only mild and transient adverse events were reported, all of which resolved spontaneously.

FxCO₂ therapy effectively improves sexual function, subjective vaginal tightness, and vaginal mucosal health in women with vaginal relaxation syndrome. The short-term efficacy is favorable, with no significant safety concerns observed.