NeoVaginal Laser (NV-Laser)

(VRS) is a common medical condition among females. VRS is described as a loss of the optimal vaginal structure. Most women (and their husbands or partners) refer to VRS as ‘loose vagina‘.

However, they delay coming forward to be treated as this a taboo topic in society.

Figure 1. Pelvic floor & endopelvic fascia

The main supports for our pelvic organs are the bony pelvis, the levatore ani muscle (pelvic floor) and endopelvic fascia (fibrous tissue that forms a mesh around the pelvic organs) as demonstrated in Figure 1.

The bony pelvis does not change much in a woman’s lifetime. However, the muscular and fascia components undergo substantial changes. The main causes of VRS are childbirth and aging.

During vaginal delivery of a baby, the pelvic floor muscles and endopelvic fascia undergo significant strain and trauma. Postnatally,the body’s natural healing restores most of the structure and power of the tissues. However, some women will notice a degree of vaginal laxity and urine leakage.

With aging, especially after menopause, there is a decrease in the body’s ability to regenerate. Hence, the pelvic floor & endopelvic fascia start to weaken leading to further ‘loosening’ of the vagina.

Traditional management for VRS

A large spectrum of treatment options is available for VRS. They range from pharmacological (hormonal, tightening creams and sprays) through behavioural therapies (Kegel exercise) to more invasive surgical procedures.

While pharmacological and behavioural therapies are non-invasive,they have limited efficacy. On the other hand, surgical procedures achieve a better final result at the price of higher associated risks.

Surgical procedures involve the cutting and rearrangement of vaginal and its neighbouring tissues. This may cause scarring, infection and painful intercourse post operation. Furthermore, the patient needs 1-3 days of hospitalisation and 4-6 weeks of hospitalisation leave from work. There will also be transient pain at the vagina / vulva area requiring pain relief medication.

NeoVaginal Laser

NeoVaginal Laser (NV-Laser) is a novel system utilising Er-YAG laser from Fotona.

How does it work?

The unique wavelength of the Er-YAG laser causes a controlled increase in tissue temperature (50-70°C) to a defined tissue depth (200-500µm). Heating of collagen causes its fibres to contract and shrink. With collagen remodelling and re-genesis, the treated tissue becomes enriched with new collagen, appearing younger, tighter and more elastic. This has been proven by tissue studies which showed increase in collagen density after Er-YAG laser treatment.

The thermal tightening effects on the collagen fibres translate to a tighter vagina and less laxity.

Histologically, increase in collagen density was demonstrated 6 months post-treatment, as shown by increased colour absorption of collagen fibres.

How good are the results?

Clinical studies have shown 70-95% improvement and patient satisfaction after treatment for VRS and mild to moderate stress urinary incontinence.

How is it done?

The process involves a state-of-the-art laser machine. The vaginal tightening procedure achieved its effects by utilising a specially designed set of speculum and laser adapter to deliver precisely controlled laser pulses to the vaginal canal and the introitus. This achieves the desired collagen remodelling and neo-collagenesis (synthesis of new collagen fibres) without adverse effects.

The procedure is done as a clinic procedure at the LC Lee Urogynae Centre

Advantages of NV-Laser

• No anaesthesia required
• Totally incisionless
• Walk-in/ walk-out clinic procedure, no downtime

However, we do advise abstinence from intercourse and swimming for 2 weeks after the procedure.

Is NV-Laser suitable for all women?

NV-Laser is suitable for most women with VRS. However, women who are photosensitive or are on photosensitive medication may need to be screened or stop their medication before treatment.

Pregnancy and some pelvic pathological conditions are contraindications for NV-Laser.

Many may be keen to come forward for NV-Laser as soon as possible after the delivery of their babies.However, our advice is to wait for 3 months post-delivery to allow natural healing to occur first, before embarking on this therapy.

Are the effects evident immediately?

NV-Laser works by the natural regeneration of collagen tissues after thermal treatment. Effects are only seen a few weeks after treatment. The number of treatments required depends largely on the woman’s ability for tissue regeneration and remodelling of the vagina collagen.

Usually 2 treatments, about 4-6 weeks apart, are required to achieve optimal results.

The Future

This innovative technology revolutionalises the management of VRS.

NV-Laser may also prevent or slow down the progression of pelvic organ prolapse* and urinary incontinence from mild to severe stage.

NB : In Singapore, NV-Laser is available in LC Lee Urogynae Centre
Please contact us for appointment/if any enquiries.

* Pelvic organ prolapse refers to the protrusion of bladder/rectum/ uterus out of the vagina.
Women with this condition often complain of a lump coming out from their vagina.
Management depends on type and severity of the prolapse.