***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives The objective of this prospect i ve comparative cohort study was to establish the effectiveness and safety of Erbium : YAG ( Er : YAG ) laser treatment for genitourinary syndrome of menopause and to compare it with an established topical estriol treatment . Methods Fifty patients with genitourinary syndrome of menopause were divided into two groups . The estriol group received a treatment of 0.5 mg estriol ovules for 8 weeks and the laser group was first treated for 2 weeks with 0.5 mg estriol ovules 3 times per week to hydrate the mucosa and then received three sessions with 2,940 nm Er : YAG laser in non‐ablative mode . Biopsies were taken before and at 1 , 3 , 6 , and 12 months post‐treatment . Maturation index , maturation value and pH where recorded up to 12‐months post‐treatment , while the VAS analysis of symptoms was recorded up to 18 months post‐treatment . Results Statistically significant ( P < 0.05 ) , reduction of all assessed symptoms was observed in the laser group at all follow‐ups up to 18 months post‐treatment . Significant improvement in maturation value and a decrease of pH in the laser group was detected up to 12 months after treatment . The improvement in all endpoints was more pronounced and longer lasting in the laser group . Histological examination showed changes in the tropism of the vaginal mucosa and also angiogenesis , congestion , and restructuring of the lamina propria in the laser group . Side effects were minimal and of transient nature in both groups , affecting 4 % of patients in the laser group and 12 % of patients in the estriol group . Conclusions Our results show that Er : YAG laser treatment successfully relieves symptoms of genitourinary syndrome of menopause  and that the results are more pronounced and longer lasting compared to topical estriol treatment . Lasers Surg . Med . 49:160–168 , 2017 . © 2016 The Authors . Lasers in Surgery and Medicine Published by Wiley Periodicals , Objective : The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepi and rosterone ( DHEA , Prasterone ) on moderate to severe dyspareunia or pain at sexual activity , the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause ( GSM ) . Methods : In a prospect i ve , r and omized , double-blind , and placebo-controlled phase III clinical trial , the effect of daily intravaginal 0.50 % DHEA ( 6.5 mg ) ( Prasterone , EndoCeutics ) was examined on four co primary objectives , namely percentage of parabasal cells , percentage or superficial cells , vaginal pH , and moderate to severe pain at sexual activity ( dyspareunia ) identified by the women as their most bothersome vulvovaginal atrophy symptom . The intent-to-treat population included 157 and 325 women in the placebo and DHEA-treated groups , respectively . Results : After daily intravaginal administration of 0.50 % DHEA for 12 weeks , when compared to baseline by the analysis of covariance test , the percentage of parabasal cells decreased by 27.7 % over placebo ( P < 0.0001 ) , whereas the percentage of superficial cells increased by 8.44 % over placebo ( P < 0.0001 ) , vaginal pH decreased by 0.66 pH unit over placebo ( P < 0.0001 ) , and pain at sexual activity decreased by 1.42 severity score unit from baseline or 0.36 unit over placebo ( P = 0.0002 ) . On the other h and , moderate to severe vaginal dryness present in 84.0 % of women improved at 12 weeks by 1.44 severity score unit compared to baseline , or 0.27 unit over placebo ( P = 0.004 ) . At gynecological evaluation , vaginal secretions , epithelial integrity , epithelial surface thickness , and color all improved by 86 % to 121 % over the placebo effect ( P < 0.0001 for all comparisons with placebo ) . Serum steroid levels remained well within the normal postmenopausal values according to the involved mechanisms of intracrinology . The only side effect reasonably related to treatment is vaginal discharge due to melting of the vehicle at body temperature and this was reported in about 6 % of the participants . Conclusions : The daily intravaginal administration of 0.50 % ( 6.5 mg ) DHEA ( Prasterone ) has shown clinical ly and highly statistically significant effects on the four co primary parameters suggested by the US Food and Drug Administration . The strictly local action of Prasterone is in line with the absence of significant drug-related adverse events , thus showing the high benefit-to-risk ratio of this treatment based upon the novel underst and ing of the physiology of sex steroids in women OBJECTIVE : To evaluate the efficacy of two vaginal doses of estradiol ( E2 ) compared with placebo in the treatment of atrophic vaginitis . METHODS : In a multi-center , r and omized , double-blind , parallel-group study , 230 postmenopausal women received treatment with 25 mcg or 10 mcg E2 or placebo for 12 weeks . Efficacy was measured through composite score of three vaginal symptoms and grading of vaginal health . Additional analyses included maturation of vaginal and urethral mucosa . Safety assessment s included endometrial biopsy , adverse events , changes in laboratory tests , and physical examinations . After 12 weeks of treatment , all patients were switched to the open-label extension and received treatment with 25 mcg E2 up to week 52 . RESULTS : Vaginal tablets with 25 mcg and 10 mcg E2 showed significant ( P<.001 ) improvement in composite score of vaginal health . Other results with 10 mcg E2 were not entirely consistent with those for 25 mcg E2 . Over 12 weeks , both active treatments result ed in greater decreases in vaginal pH than placebo . There were no significant differences between the 25 mcg and 10 mcg E2 groups in terms of improvements in maturation value or composite score of three vaginal symptoms . The efficacy was maintained to week 52 with 25 mcg E2 . CONCLUSION : Vaginal tablets with 25 mcg and 10 mcg E2 provided relief of vaginal symptoms , improved urogenital atrophy , decreased vaginal pH , and increased maturation of the vaginal and urethral epithelium . Those improvements were greater with 25 mcg than with 10 mcg E2 . Both doses were effective in the treatment of atrophic vaginitis . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00465192 and NCT00464971 LEVEL OF EVIDENCE : AIMS To determine whether changes in question naire scores on symptoms and condition-specific quality of life reflect clinical ly relevant improvements in women with stress urinary incontinence ( SUI ) . METHODS We retrospectively analyzed question naires collected during a r and omized controlled trial in women with SUI , that received pelvic floor muscle training ( PFMT ) in two different formats . We included 218 women that answered vali date d self- assessment question naires  at baseline and at a 4-month follow-up . We registered changes on two question naires , the International Consultation on Incontinence Modular Question naire-Urinary Incontinence Short Form ( ICIQ-UI SF ) and the Lower Urinary Tract Symptoms Quality of Life ( ICIQ-LUTSqol ) . We compared these score changes to responses from the Patient Global Impression of Improvement ( PGI-I ) question naire . Differences were analyzed with the Spearman rho and one-way-ANOVA . The minimum important difference ( MID ) was the mean change in score for women that experienced a small improvement . RESULTS The PGI-I correlated significantly to both the ICIQ-UI SF ( r = 0.547 , P < 0.0001 ) and ICIQ-LUTSqol ( r = 0.520 , P < 0.0001 ) . Thus , larger reductions in symptoms or quality of life scores were associated with greater impressions of improvement . The changes in ICIQ-UI SF and ICIQ-LUTSqol scores were significant across all PGI-I groups from " no change " to " very much improved " ( P < 0.05 ) . The MIDs were 2.52 ( SD 2.56 ) for ICIQ-UI SF and 3.71 ( SD 4.95 ) for ICIQ-LUTSqol . CONCLUSIONS The change in ICIQ-UI SF and ICIQ-LUTSqol scores after PFMT reflected clinical ly relevant improvements in women with SUI . The MIDs established for this population may facilitate future research , treatment evaluations , and comparisons between studies Introduction and hypothesisThe impact of the IncontiLaseTM procedure on  lower urinary tract symptoms ( LUTS ) remains unclear . Our aim was to evaluate the effects of the IncontiLaseTM procedure for urodynamic stress incontinence ( USI ) . Methods All consecutive women with USI prospect ively underwent the IncontiLaseTM procedure .  Urodynamic studies , pad testing , LUTS , and sexual function question naires were assessed before and after treatment . Results Thirty-five women underwent the IncontiLaseTM procedure . Among the 28 women with baseline pad weights > 1 g , 11 ( 39.3 % ) were objective ly cured and 11 ( 39.3 % ) improved . Among the 18 women with mild USI ( i.e. , baseline pad weight 1–10 g ) , nine ( 50 % ) were cured and five ( 27.8 % ) improved . Among ten women with baseline pad weight > 10 g , two ( 20 % ) were cured and six ( 60 % ) improved . Among the 32 women with complete question naire data at 6 months , seven ( 21.9 % ) were subjectively cured , and four ( 12.5 % ) improved . Regarding LUTS , the majority of domains on the King ’s Health Question naire and female sexual desire and function exhibited significant improvements . Forty percent ( 12/30 ) of the partners of these patients felt their sexual function had improved at 6 months . Nonetheless , urodynamic values did not differ across the timeline . Conclusions The effect of the IncontiLaseTM procedure for mild USI was moderate at 6-month follow-up but was not effective for pad weight > 10 g. Moreover , it improved LUTS , quality of life , QoL , and sexual function of both partners . Further studies should be performed to assess long-term sustained efficacy OBJECTIVE To evaluate the efficacy of laser photothermal therapy in a group of Chilean women with SUI . MATERIAL AND METHODS Longitudinal prospect i ve study based on 42 women with mild-to-severe SUI , intervened with non ablative Er : YAG laser , between July 2014 and October 2015 , in Santiago , Chile . The therapy efficacy was evaluated through the difference between every patient 's scores obtained , before and after treatment , with the International Consultation on Incontinence Question naire - Urinary Incontinence Short Form ( ICIQ-SF ) , at a confidence level of 95 % . Also , the patient satisfaction with treatment was reported through an ordinal scale . RESULTS ICIQ-SF median score was 11 before treatment and 3 after 6 months , with a significant difference per patient ( p<0.001 ) . 78.6 % ( n=33 ) reported improvement and 38.1 % ( n=16 ) , a complete healing of SUI at follow up . 66.7 % ( n=28 ) reported high satisfaction and 81.8 % ( n=27 ) of sexually active women , also reported improvement of sexual gratification . Only mild pain during the procedure was reported as adverse effect . CONCLUSIONS Based on this short-term pilot study , non-ablative Er : YAG laser procedure seems to be a safe and efficacious alternative for patients with SUI . Further controlled studies will help to vali date the use of non-ablative Er : YAG for treatment of SUI Objectives : The aim of the study was to assess the safety and efficacy of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause ( GSM ) . Methods : Women presenting with GSM and meeting study criteria were enrolled . Examinations at baseline and follow-up ( 3 mo after final treatment ) evaluated dilator tolerance and vaginal pH. Visual analog scales were used to assess pain , vaginal burning , vaginal itching , vaginal dryness , dyspareunia , and dysuria ; Vaginal Health Index scores were completed before each treatment and at follow-up ; Female Sexual Function Index and Short Form 12 question naires were also completed . Participant satisfaction was measured on a 5-point Likert scale ( 1 = very dissatisfied , 5 = very satisfied ) . Women received three laser treatments , 6 weeks apart . Results : Thirty women participated ( mean age 58.6 ± 8.8 y ) . None withdrew or were discontinued due to an adverse event ; three were lost to follow-up . Average improvement in visual analog scale scoring was 1.7 ± 3.2 for pain , 1.4 ± 2.9 for burning , 1.4 ±  
    Output:
    
Furthermore , KHQ , UDI-6 , MCS12/PCS12 , FSFI , overall sexual satisfaction and measurements of the effect of laser therapy  on the local pathophysiology improved significantly .
In conclusion , laser therapy for postmenopausal women with GSM appears promising .
It may reduce symptom severity , improve quality of life of postmenopausal women and restore the vaginal mucosa to premenopausal status .