Erbium laser treatment for relief of long-term symptoms related to episiotomyscars – 1-year follow-up

Abstract

Purpose: The purpose of this study was to evaluate erbium YAG (Er:YAG) laser treatment for long-term symptoms related to episiotomy scars. Methods: This single-arm study included patients with episiotomy scar complaining of at least one of the following: dyspareunia, pain while sitting, pain at pressure, pulling, bumps at perineum, and bleeding after intercourse. 110 patients received three Er:YAG laser treatment sessions in a two-step protocol: full spot cold ablation along the scar, and fractional ablation across the whole episiotomy surface. Improvement and side effects were monitored at every treatment and 3 and 12 months after the last procedure. Results: All patients achieved improvement and 52.7% became symptom free. Average improvement at 12 months was 9.1±1.1 on a 0–10 scale. Average pain during the procedure (without anesthesia) was 5.4/10. Side effects were mild and transient. Conclusion: Laser treatment for episiotomy scars is an excellent candidate as a less invasive alternative to surgery.