Safety and efficacy of fractional CO₂ laser treatment to the vestibule: a randomized, double-blind, sham-controlled, prospective 3-site clinical study in women with vestibular pain.

This article reports on the first multisite, prospective, randomized, double-blind, sham-controlled clinical trial assessing the safety and efficacy of fractional CO₂ laser therapy applied to the vestibule in women with vestibular pain. Seventy women with vestibular pain, many of whom were unable or unwilling to use hormonal treatments, received three treatments of either active or sham fractional CO₂ laser using a dedicated vestibular probe. The study found significant improvements in vestibular tissue health, pain reduction, sexual function, and urinary symptoms after active treatment, with no significant changes in the sham group and no serious adverse events reported. These findings suggest that fractional CO₂ laser therapy is a safe and effective nonhormonal treatment option for vestibular pain, though further research including histologic studies and comparisons with hormone therapy is recommended.