In the last decade, there has been an ever-growing user demand for minimally invasive procedures for treating symptoms of pelvic floor dysfunction. Some of the most promising treatments were developed using energy-based devices, such as lasers (Erbium:YAG and CO2) and radiofrequency.
The FotonaSMOOTHVR non-ablative thermal-only Er:YAG technology1 (Fotona, Ljubljana, Slovenia) has been specially developed for minimally invasive intravaginal treatments. Four different treatment protocols that incorporate non-ablative thermal-only Er:YAG technology have been developed and
clinically validated for the following indications: stress urinary incontinence (SUI)2, vaginal laxity/vaginal relaxation syndrome3, genitourinary syndrome of menopause (GSM)/vulvovaginal atrophy (VVA)4, and pelvic organ prolapse (POP)5.
The non-ablative thermal-only Er:YAG technology works by creating rapid sequential heat pulses that are transferred deeper into mucosa (up to 500 mm), without overheating the tissue surface. As a result of this precisely controlled heating, the temperature in the vaginal wall increases to approximately 65 C, the optimal temperature that allows the shorteningof the collagen fibrils without irreversible denaturation
of their structure6. Shortening of the collagen fibrils leads to contraction and shortening of the irradiated mucosal tissue.