The use of vaginal laser therapy (VLT) significantly reduces cystitis episodes and improves vaginal health in postmenopausal women, according to a study presented at EAU26.
Recurrent cystitis affects 20–40 percent of women, with 25–50 percent experiencing frequent recurrences, particularly postmenopausal women, markedly impairing their quality of life, said study author Dr Eriko Kasuya from the Jikei University School of Medicine in Tokyo, Japan.
Antibiotic therapy is the primary treatment for recurrent cystitis. However, the long-term use of antibiotics has raised concerns about antimicrobial resistance, which highlights the need for alternative therapies, Kasuya noted.
Hence, the researchers conducted a retrospective cohort study involving 51 postmenopausal women (mean age 63 years) with recurrent cystitis, defined as ≥3 episodes/year or ≥2 in 6 months requiring antibiotics.
The participants underwent a pretreatment phase with oestriol ovules, followed by VLT for 3–6 cycles. At baseline, all women had a vaginal pH of >5.5 and were free of urinary tract malignancy or pelvic infection. [EAU26, abstract A0149]
Results showed that the median number of cystitis episodes significantly decreased from 4 at baseline to zero within 6 months after treatment (p<0.001).
The median cystitis-free interval, defined as the time from the initiation of VLT to cystitis occurrence, was 9.2 months.
Regarding changes in the vaginal environment, the median Vaginal Health Index (VHI) score significantly improved from 10 at baseline to 18 post-treatment, and the median vaginal pH significantly decreased from 8 to 5.5 (p<0.001 for both).
Additionally, a cystoscopy was performed to assess both vaginal and periurethral tissue conditions, demonstrating that after treatment, the periurethral atrophy had improved and the purulent vaginal discharge had disappeared.
“The improvements in vaginal tissue health, pH, and VHI observed in our patients indicate that VLT can positively influence the vaginal microenvironment,” the researchers noted in a published paper. [Lasers Surg Med 2025;57:700-707]
In terms of adverse events, only four (7.8 percent) patients experienced vaginal pain (5.9 percent) or dyspareunia (2 percent), both of which were classified as grade 1 in severity.
Overall, “these findings suggest that VLT may represent a safe and effective alternative for recurrent cystitis by targeting the underlying vaginal microenvironment,” said Kasuya.
“Our findings provide strong preliminary evidence supporting the potential efficacy of VLT for recurrent cystitis,” the researchers added.